Individual
NELLIE C STREET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
110 WEST MAIN, SUITE 1, LEBANON, VA 24266
(276) 889-1919
(276) 889-4635
Mailing address
RR 2 BOX 413, HONAKER, VA 24260-9501
(276) 859-2854
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202010455
VA
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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