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General NPI Number Information
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NPI Number | 1245252345
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Entity Type | Individual
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Provider Name | LISA A STRUCKO PHARM D
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Gender | Female
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 36-C CATOCTIN CIRCLE, SE
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City | LEESBURG
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State | VA
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Zip | 20175
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Country | US
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Telephone | 703-777-5333
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Fax | 703-771-8246
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Provider Business Mailing Address
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Address Line | 42950 CLOVER LEAF CT
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City | ASHBURN
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State | VA
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Zip | 20148
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Country | US
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Telephone | 571-333-8880
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202206251
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License Number State | VA
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