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Individual

TERENCE JOSEPH CUSACK IV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2575
(910) 450-4515
Mailing address
401 HOLLAND LN, 513, ALEXANDRIA, VA 22314-3428
(760) 464-8022

Taxonomy

Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
67215
CA

Other

Enumeration date
09/25/2012
Last updated
09/30/2025
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