Individual
DR. KIM SISOUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
3480 S JEFFERSON ST, FALLS CHURCH, VA 22041-3104
(703) 931-1333
(844) 411-6528
Mailing address
6710 PORTREE CT, SPRINGFIELD, VA 22152-2933
(707) 217-6997
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202215342
VA
183500000X
Pharmacist
24641
MD
183500000X
Pharmacist
PH100002630
DC
Other
Enumeration date
02/04/2019
Last updated
11/03/2020
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