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Individual

IREN ROSE ATHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
15000 AFTON COURT, MONTCLAIR, VA 22025-1038
(703) 878-8334
Mailing address
15000 AFTON COURT, MONTCLAIR, VA 22025-1038
(703) 878-8334

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary

Other

Enumeration date
09/30/2019
Last updated
09/30/2019
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