Individual
FANNY DESPOTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
4670 CASEY BLVD, WILLIAMSBURG, VA 23188-2879
(757) 603-4607
Mailing address
4670 CASEY BLVD, WILLIAMSBURG, VA 23188-2879
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
69375
CA
Other
Enumeration date
11/10/2015
Last updated
07/08/2022
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