Individual
MRS. NATASHA RENEE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
4524 CHALLENGER AVE, ROANOKE, VA 24012-7028
(540) 977-4881
Mailing address
35 TIMS ORCHARD RD, TROUTVILLE, VA 24175-7158
(276) 210-7842
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202210888
VA
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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