MARYAM N/A NICKSOLAT

MC LEAN, VA
NPI1215027545
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: VA  0110001340)
Enumeration Date2006-10-16
Last Update Date2017-04-24
Business Address
-- MARYAM N/A NICKSOLAT
8370 GREENSBORO DR
MC LEAN, VA 22102-3515
Phone number: 703-200-7727
Mailing Address
-- MARYAM N/A NICKSOLAT
8370 GREENSBORO DR
MC LEAN, VA 22102-3515
Phone number: 703-200-7727