Individual
FARHAD KHAMISSIZADEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14904 JEFFERSON DAVIS HWY STE 101, WOODBRIDGE, VA 22191-3908
(703) 910-6044
Mailing address
14904 JEFFERSON DAVIS HWY STE 101, WOODBRIDGE, VA 22191-3908
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202012238
VA
Other
Enumeration date
04/22/2020
Last updated
04/22/2020
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