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Individual

POWUM BENNAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
16793 CAPON TREE LN, WOODBRIDGE, VA 22191-5134
(571) 481-1842
Mailing address
9555 KINGS CHARTER DR STE D, ASHLAND, VA 23005-7994
(800) 753-0596
(804) 799-7917

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202216219
VA

Other

Enumeration date
12/03/2020
Last updated
12/03/2020
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