Individual
LISA WILCOX FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
3545 CHAIN BRIDGE RD STE 102, FAIRFAX, VA 22030-2708
(571) 732-4633
(571) 732-4643
Mailing address
3545 CHAIN BRIDGE RD STE 102, FAIRFAX, VA 22030-2708
(571) 732-4633
(571) 732-4643
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202220418
VA
183500000X
Pharmacist
022865
KY
183500000X
Pharmacist
03331630
OH
183500000X
Pharmacist
057706
NY
183500000X
Pharmacist
08982
MS
183500000X
Pharmacist
1-117754
KS
183500000X
Pharmacist
17573
NE
183500000X
Pharmacist
19233
AL
183500000X
Pharmacist
22963
NV
183500000X
Pharmacist
24188
MD
183500000X
Pharmacist
5302414520
MI
183500000X
Pharmacist
PH236963
MA
183500000X
Pharmacist
PST.021598
LA
183500000X
Pharmacist
R-19700
OK
183500000X
Pharmacist
S021905
AZ
Other
Enumeration date
02/08/2016
Last updated
11/06/2023
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