Individual
KODI-MICALE REID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13800 HULL STREET RD, MIDLOTHIAN, VA 23112-2002
(804) 739-2198
Mailing address
13800 HULL STREET RD, MIDLOTHIAN, VA 23112-2002
(804) 739-2198
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202221485
VA
Other
Enumeration date
10/24/2023
Last updated
10/24/2023
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