Individual
MALCOLM LAVAUGHAN MASSENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3330 S CRATER RD, PETERSBURG, VA 23805-9277
(804) 863-0983
Mailing address
1118 GLIDEWELL RD, RICHMOND, VA 23227-1431
(703) 987-1503
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202005260
VA
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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