Most Relevant Information
Provider Data
| NPI Number: | 1003672601 |
| Provider Name: | GLORIA JISUN KIM PHARMD |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 0202213754 |
Most Important Dates
| Enumeration Date: | 02/22/2024 |
| Last Updated: | 02/22/2024 |
Provider Practice Location
1510 NORTHERN NECK DR
102
VIENNA
VA
22182
Practice Location Phone/Fax
| Phone: | 7037953804 |
| Fax: |
Provider Mailing Location
1510 NORTHERN NECK DR
102
VIENNA
VA
22182
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |