Individual
DR. ALYSSA DAVIS BASTUG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D., MPH
Contact information
Practice address
7045 FOREST HILL AVE, RICHMOND, VA 23225-1661
(804) 253-0351
Mailing address
7045 FOREST HILL AVE, RICHMOND, VA 23225-1661
(804) 253-0351
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
0202215722
VA
1835P1200X
Pharmacotherapy Pharmacist
26481
NC
1835P1200X
Pharmacotherapy Pharmacist
36820
SC
Other
Enumeration date
09/14/2016
Last updated
12/10/2018
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