DR. Wade Lewis Mckinnon JR., PHARMD

NPI #1720363864 in Ashburn, Virginia

Provider Information

NPI Number: 1720363864
Entity Type: Individual
Name: DR. Wade Lewis Mckinnon JR., PHARMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Credential: PHARMD
Enumeration Date: Oct 20, 2011
Last Updated: Oct 20, 2011

Practice Location

Address: 42820 CREEK VIEW PLZ
City: Ashburn
State: Virginia
ZIP Code: 20147-4036
Phone: (703) 259-6683

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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