Individual
JASON VAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20908 FREDERICK RD, GERMANTOWN, MD 20876-4134
(301) 515-0189
Mailing address
3950 BRAVEHEART CIR, FREDERICK, MD 21704-7743
(240) 535-2017
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
29317
MD
Other
Enumeration date
08/16/2023
Last updated
08/16/2023
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