Individual
ALEXIS PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
164 CAMP CREEK PKWY, ZION CROSSROADS, VA 22942-6878
Mailing address
7236 AUBURN ST, ANNANDALE, VA 22003-5818
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202217152
VA
Other
Enumeration date
10/30/2020
Last updated
10/30/2020
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