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Kimberly Manning
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NPI Number Detailed Information
Provider Information:
| Name: | Kimberly Manning |
| Gender: | F |
| Provider License Number If Given: | 24164468 |
NPI Information:
| NPI: | 1417942921 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 9/12/2005 |
| Last Update Date: | 7/8/2007 |
Provider Business Mailing Address:
| Address: | 8100 ASHTON AVE SUITE 101 Manassas, VA 20109 |
| Phone Number: | 7032578090 |
| Fax Number: | 7032577822 |
Provider Business Practice Location Address:
| Address: | 8100 ASHTON AVE SUITE 101 Manassas, VA 20109 |
| Phone Number: | 7032578090 |
| Fax Number: | 7032577822 |
Provider Taxonomy:
| Primary: | 363LF0000X |
| Secondary (if any): | |
| State: | VA |
