| NPI | 1174648190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELE C. FISHER Mtm Pharmacist 757-874-3047 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202207246) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-08-22 |