Individual
NGA T VU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1230 W BROAD ST, FALLS CHURCH, VA 22046-2116
(703) 536-0954
Mailing address
8142 OLD DOMINION DR, MC LEAN, VA 22102-1310
(571) 277-9095
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202206398
VA
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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