Individual
SUZANNE M GONGLOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
104 SELMA DR, WINCHESTER, VA 22601-3834
(540) 678-2800
Mailing address
104 SELMA DR, WINCHESTER, VA 22601-3834
(540) 678-2800
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110001482
VA
Other
Enumeration date
01/12/2006
Last updated
02/24/2010
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