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1538847348
KONSTANTIN SERGEYEVICH GUTNICHENKO
FAIRFAX, VA
NPI
1538847348
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
246ZC0007X Specialist/Technologist, Other, Surgical Assistant
(Licence: VA 0136000798)
Enumeration Date
2023-07-11
Last Update Date
2023-07-11
Business Address
KONSTANTIN SERGEYEVICH GUTNICHENKO
12011 LEE JACKSON HWY STE 501
FAIRFAX, VA 22033-3315
Phone number: 703-259-7027
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Mailing Address
KONSTANTIN SERGEYEVICH GUTNICHENKO
PO BOX 221135
CHANTILLY, VA 20153-1135
Phone number: 703-259-7027
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