Individual
ALLISON PHILLIPS GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 853-0961
Mailing address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202214877
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202214877
VIRGINIA PHARMACIST LICENSE NUMBER
VA
Enumeration date
11/08/2018
Last updated
11/08/2018
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