Individual
MR. AFEWORK YACOB TANTU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5021 SEMINARY RD, APT#1109, ALEXANDRIA, VA 22311-1945
(571) 239-0621
Mailing address
5021 SEMINARY RD, APT#1109, ALEXANDRIA, VA 22311-1945
(571) 239-0621
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
1316
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000
—
DC
Enumeration date
07/19/2007
Last updated
07/19/2007
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