Individual
CRIS ANTAO DIGAMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAB TECHNICIAN
Contact information
Practice address
14422 COOL OAK LN, CENTREVILLE, VA 20121-2235
(202) 247-1812
(800) 887-9017
Mailing address
14422 COOL OAK LN, CENTREVILLE, VA 20121-2235
(202) 247-1871
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
20-0217R
MD
Other
Enumeration date
03/24/2022
Last updated
03/24/2022
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