Individual
CASSANDRA POULLATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9401 LIBERIA AVE, MANASSAS, VA 20110-1718
(703) 257-0864
(703) 257-6356
Mailing address
8100 LANDFALL CT, GAINESVILLE, VA 20155-3803
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202207998
VA
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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