Organization
JANET AVERY MD PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KETKESONE NANTHAVONGSA (BILLER)
(703) 986-7175
Entity
Organization
Contact information
Practice address
1860 TOWN CENTER DR, SUITE 310, RESTON, VA 20190-5896
(703) 481-5907
(703) 435-0660
Mailing address
1860 TOWN CENTER DR, SUITE 310, RESTON, VA 20190-5896
(703) 481-5907
(703) 435-0660
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/03/2010
Last updated
05/03/2010
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