Individual
JAISON DANIEL PERDUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
36115 GOODWIN DR, LOCUST GROVE, VA 22508-2029
(703) 268-8463
Mailing address
36115 GOODWIN DR, LOCUST GROVE, VA 22508-2029
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202210088
VA
Other
Enumeration date
12/02/2020
Last updated
12/02/2020
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