ANTONIETTA E VAILLANCOURT

GAITHERSBURG, MD
NPI1811403033
Former NameANTONIETTA E IOSUE
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: MD  C06707)
Additional Taxonomies363AM0700X Physician Assistant, Medical
(Licence: HI  AMD-789)
Enumeration Date2017-12-26
Last Update Date2024-02-20
Business Address
ANTONIETTA E VAILLANCOURT PA
9561 WHITE PILLAR TER
GAITHERSBURG, MD 20882-2816
Phone number: 301-641-8354
Mailing Address
ANTONIETTA E VAILLANCOURT PA
23600 ROLLING FORK WAY
GAITHERSBURG, MD 20882-2808
Phone number: 301-641-8354