Individual
MARISSA ZACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
9271 SUDLEY RD, MANASSAS, VA 20110-5222
(571) 292-8722
Mailing address
901 N NELSON ST APT 709, ARLINGTON, VA 22203-1733
(814) 528-1518
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202220026
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MZACK18
N/A
—
Enumeration date
12/03/2021
Last updated
12/03/2021
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