ANGELIQUE V BLACK

RESTON, VA
NPI1932127644
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: VA  0110002122)
Enumeration Date2006-07-18
Last Update Date2007-07-08
Business Address
-- ANGELIQUE V BLACK PA
1850 TOWN CENTER PARKWAY SUITE 400
RESTON, VA 20190
Phone number: 703-689-0300
Mailing Address
-- ANGELIQUE V BLACK PA
11240 WAPLES MILL ROAD SUITE 403
FAIRFAX, VA 22030
Phone number: 703-246-8080
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