Individual
MARI KRISEL LANTIN SALAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
199 REEDSDALE RD, MILTON, MA 02186-3926
(617) 696-4600
Mailing address
2722 MERRILEE DR, STE 230, FAIRFAX, VA 22031-4400
(703) 698-4444
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110007749
VA
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
03/18/2016
Last updated
11/07/2024
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