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General NPI Number Information
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NPI Number | 1780952432
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Entity Type | Individual
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Provider Name | CHRISTINE GRACE CORSER PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 12/09/2011
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Last Update Date | 12/09/2011
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Provider Practice Location Address
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Address Line | 3801 JEFFERSON DAVIS HWY
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City | ALEXANDRIA
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State | VA
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Zip | 22305-3118
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Country | US
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Telephone | 703-539-9151
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Fax |
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Provider Business Mailing Address
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Address Line | 7763 NEW PROVIDENCE DR APT 54
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City | FALLS CHURCH
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State | VA
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Zip | 22042-4424
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Country | US
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Telephone | 703-539-9151
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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 | 0202210131
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License Number State | VA
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