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Individual

LOGAN JAMES ADKISSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
14125 SAINT GERMAIN DR, CENTREVILLE, VA 20121-2310
(703) 631-7720
Mailing address
5806 STREAM POND CT, CENTREVILLE, VA 20120-5421

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202221668
VA

Other

Enumeration date
10/30/2023
Last updated
10/30/2023
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Product
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