Individual
ANNALISA DIVITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14801 DINING WAY, WOODBRIDGE, VA 22191-4075
(703) 763-5545
Mailing address
9217 MATTHEW DR, MANASSAS PARK, VA 20111-2451
(781) 974-9171
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202220565
VA
Other
Enumeration date
07/18/2023
Last updated
05/21/2024
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