Most Relevant Information
Provider Data
| NPI Number: | 1003206665 |
| Provider Name: | JOHANA QUISPE |
| Entity Type: | Individual |
| Taxonomy Code: | 183700000X |
| Specialty: | Pharmacy Technician |
| License Number: | 0230015838 |
Most Important Dates
| Enumeration Date: | 02/03/2015 |
| Last Updated: | 02/03/2015 |
Provider Practice Location
46201 POTOMAC RUN PLZ
STERLING
VA
201646609
Practice Location Phone/Fax
| Phone: | 7034448452 |
| Fax: |
Provider Mailing Location
46201 POTOMAC RUN PLZ
STERLING
VA
201646609
Provider Mailing Phone/Fax
| Phone: | 7034448452 |
| Fax: |