Individual
ANNALISA W FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4101 W VERNON AVE, KINSTON, NC 28504-9672
(252) 527-8400
Mailing address
11233B NC 55 HWY, GRANTSBORO, NC 28529-9471
(252) 745-6004
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
27375
NC
Other
Enumeration date
12/20/2017
Last updated
12/01/2020
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