Individual
LEAH PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6118 ARLINGTON BLVD, FALLS CHURCH, VA 22044-2901
(703) 531-0034
Mailing address
2602 BOWLING GREEN DR, VIENNA, VA 22180-7027
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202207950
VA
Other
Enumeration date
12/09/2010
Last updated
12/09/2010
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