DR. Jason Shane Wilson, PHARMD

NPI #1396029989 in Ashburn, Virginia

Provider Information

NPI Number: 1396029989
Entity Type: Individual
Name: DR. Jason Shane Wilson, PHARMD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Credential: PHARMD
Enumeration Date: Oct 1, 2011
Last Updated: Oct 1, 2011

Practice Location

Address: 43250 SOUTHERN WALK PLZ
City: Ashburn
State: Virginia
ZIP Code: 20148-4462
Phone: (703) 729-0693

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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