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Organization

PWNC PC CORP

Active
Other names
Prince William Neuroscience Center
Organization subpart
No

Provider details

NPI number
Authorized official
DR. YVETTE C SANDOVAL M.D. (NEURO PRESIDENT)
(703) 369-0600
Entity
Organization

Contact information

Practice address
8650 SUDLEY RD, SUITE 300, MANASSAS, VA 20110-4419
(703) 369-0600
(703) 369-7487
Mailing address
8650 SUDLEY RD, SUITE 300, MANASSAS, VA 20110-4419
(703) 369-0600
(703) 369-7487

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101059282
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0007111673
VA
Enumeration date
10/24/2006
Last updated
10/03/2011
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