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General NPI Number Information
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NPI Number | 1649393513
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Entity Type | Organization
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Legal Business Name | MANUS CENTER, PC
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Dates
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Enumeration Date | 04/07/2007
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Last Update Date | 11/28/2007
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Provider Practice Location Address
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Address Line | 415 CHURCH ST NE SUITE 101
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City | VIENNA
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State | VA
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Zip | 22180-4742
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Country | US
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Telephone | 703-242-6363
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Fax | 703-242-6368
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Provider Business Mailing Address
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Address Line | 415 CHURCH ST NE SUITE 101
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City | VIENNA
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State | VA
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Zip | 22180-4742
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Country | US
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Telephone | 703-242-6363
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Fax | 703-242-6368
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MS. LINDA S. SHULER
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Credential |
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Telephone | 703-242-6363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0021522872
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License Number State | VA
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