Individual
CARL NIELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
25050 RIDING PLZ, CHANTILLY, VA 20152-5925
(703) 542-2990
(703) 542-2953
Mailing address
25050 RIDING PLZ, CHANTILLY, VA 20152-5925
(703) 542-2990
(703) 542-2953
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202010225
VA
Other
Enumeration date
11/05/2020
Last updated
11/05/2020
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