Individual
ROSELLER BALAGTAS SIMBULAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
16245 CATENARY DR, WOODBRIDGE, VA 22191-6035
(571) 214-9320
Mailing address
16245 CATENARY DR, WOODBRIDGE, VA 22191-6035
(571) 214-9320
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001301746
VA
163W00000X
Registered Nurse
RN500006216
DC
Other
Enumeration date
07/22/2024
Last updated
10/08/2024
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