Individual
MS. MARY ANN FORT
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
400 LIBBIE AVE, RICHMOND, VA 23226-2616
(804) 285-8619
Mailing address
2700 LEAFIELD TER, MIDLOTHIAN, VA 23113-6040
(804) 897-0686
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202204180
VA
Other
Enumeration date
09/09/2005
Last updated
07/08/2007
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