Individual
BEHAILU ZELEKE DESTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
13870 PARK CENTER RD, HERNDON, VA 20171-3216
(703) 796-1188
(703) 796-2277
Mailing address
13954 MANSARDE AVE, #272, HERNDON, VA 20171-6318
(703) 677-2612
(703) 870-7750
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202209123
VA
Other
Enumeration date
07/10/2012
Last updated
07/10/2012
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