Individual
KEVIN RAY DESHAZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACY TECHNICIAN
Contact information
Practice address
4508 MINE RD, FREDERICKSBURG, VA 22408-2616
(540) 845-5525
Mailing address
4508 MINE RD, FREDERICKSBURG, VA 22408-2616
(540) 845-5525
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
0230022201
VA
Other
Enumeration date
03/11/2025
Last updated
03/11/2025
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