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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

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