Individual
MARY SUSIE MELVIN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
6300 MADDOX BLVD, CHINCOTEAGUE ISLAND, VA 23336-2617
(757) 336-3115
Mailing address
3111 RIDGE RD, CHINCOTEAGUE ISLAND, VA 23336-1325
(757) 336-6063
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
0230000646
VA
Other
Enumeration date
09/29/2005
Last updated
07/08/2007
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