Old Town Manassas Medical Center

NPI 1184027161 - Clinic/Center - 261Q00000X

NPI Details
NPI 1184027161
Enumeration Date 10/03/2014
Last Updated 10/03/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name FLAVIANO FLAVIANO
Position OWNER
Phone (703) 365-0397
Fax (703) 365-0399
Practice Location
9003 CHURCH ST
MANASSAS VA, 20110-5410, US
Phone (703) 365-0397
Fax (703) 365-0399
Business Location
9003 CHURCH ST
MANASSAS VA, 20110-5410, US
Phone (703) 365-0397
Fax (703) 365-0399
Toxanomy
Taxonomy Code 261Q00000X
License State Virginia
License Number 0663198-0
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According to our database, Old Town Manassas Medical Center NPI is 1184027161, taxonomy code is 261Q00000X and license number is 0663198-0, license state is located at Virginia. Old Town Manassas Medical Center physically located at 9003 Church St, Manassas VA, 20110-5410. NPI Number 1033115704 has the healthcare provider type.

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1184027161 NPI number is provided on an as is basis without warranty of any kind. 1184027161 is maintained by the National Plan & Provider Enumeration System. The contents of Old Town Manassas Medical Center are for informational purposes only.