Individual
MR. ALAN PAUL THERIAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
10110 BATTLEVIEW PKWY STE 100, MANASSAS, VA 20109-2375
(712) 811-1285
Mailing address
9216 PORTNER AVE, MANASSAS, VA 20110-5003
(315) 374-0003
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
041451
NY
Other
Enumeration date
12/13/2007
Last updated
01/05/2023
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