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1164167318
IVAN WESLEY WISCO
CHARLOTTESVILLE, VA
NPI
1164167318
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: VA 0202220011)
Enumeration Date
2022-05-02
Last Update Date
2022-05-02
Business Address
IVAN WESLEY WISCO
1170 EMMET ST N
CHARLOTTESVILLE, VA 22903-4836
Phone number: 434-293-9151
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Mailing Address
IVAN WESLEY WISCO
1170 EMMET ST N
CHARLOTTESVILLE, VA 22903-4836
Phone number:
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