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Individual

MR. IDDRISA FYNN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
16719 CHOWNING CT, WOODBRIDGE, VA 22191-4606
(170) 378-6894
Mailing address
16719 CHOWNING CT, WOODBRIDGE, VA 22191-4606
(703) 786-8941

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
10961131-2023
VA

Other

Enumeration date
06/22/2023
Last updated
06/22/2023
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