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Individual

MRS. CECILIA M CARBALLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.PH

Contact information

Practice address
13047 FAIR LAKES SHOPPING CTR, T1341, FAIRFAX, VA 22033-5179
(703) 449-8186
(703) 449-8186
Mailing address
13047 FAIRLAKES SHOPPING CTR, T1341, FAIRFAX, VA 22033
(703) 449-8182
(703) 449-8182

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202204493
VA

Other

Enumeration date
12/01/2011
Last updated
12/01/2011
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