LONG LA

CHESTER, VA
NPI1225589690
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy183500000X Pharmacist
(Licence: MD  24540)
Enumeration Date2016-10-20
Last Update Date2016-10-20
Business Address
-- LONG LA
4238 W HUNDRED RD
CHESTER, VA 23831-1505
Phone number: 804-706-1419
Mailing Address
-- LONG LA
606 OAKLAND HILLS DR APT 301
ARNOLD, MD 21012-2026
Phone number: 240-461-7034
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