Individual
JEA YEON SHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12445 HEDGES RUN DR, LAKE RIDGE, VA 22192-1715
(703) 491-7694
(844) 411-6529
Mailing address
12445 HEDGES RUN DR, LAKE RIDGE, VA 22192-1715
(703) 491-7694
(844) 411-6529
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202205854
VA
Other
Enumeration date
11/06/2020
Last updated
11/06/2020
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