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Individual

GEORGINA THELMA KOOMSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
7951 RICHMOND HWY, APT. # 31, ALEXANDRIA, VA 22306-3019
(571) 313-9339
Mailing address
7951 RICHMOND HWY, APT. # 31, ALEXANDRIA, VA 22306-3019
(571) 313-9339

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
A60067095
VA

Other

Enumeration date
03/05/2015
Last updated
03/05/2015
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