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WOODBRIDGE, VA
NPI1487539839
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy163WE0003X Registered Nurse, Emergency
(Licence: VA  0001233700)
Enumeration Date2025-08-06
Last Update Date2025-08-06
Business Address
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2300 OPITZ BLVD
WOODBRIDGE, VA 22191-3311
Phone number: 703-523-1512
Mailing Address
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4332 GREENBERRY LN
ANNANDALE, VA 22003-3219
Phone number: 703-523-1512
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