Individual
MR. KENNETH ROBERT ERICKSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2636 MOUNTAIN VIEW RD, STAFFORD, VA 22556-6251
(540) 907-7436
Mailing address
2636 MOUNTAIN VIEW RD, STAFFORD, VA 22556-6251
(540) 907-7436
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202204436
VA
Other
Enumeration date
08/18/2011
Last updated
08/18/2011
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