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1043274368
STANLEY IDICULLA
HERNDON, VA
NPI
1043274368
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
213ES0131X Podiatrist, Foot Surgery
(Licence: VA xxxx)
Enumeration Date
2006-04-13
Last Update Date
2013-12-18
Business Address
Dr. STANLEY IDICULLA DPM
112 ELDEN ST SUITE D
HERNDON, VA 20170-4874
Phone number: 703-437-5353
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Mailing Address
Dr. STANLEY IDICULLA DPM
112 ELDEN ST SUITE D
HERNDON, VA 20170-4874
Phone number: 703-437-5353
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