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Individual

IVAN SANTOS MANASAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT, CSRS, PTRP

Contact information

Practice address
4922 LASALLE RD, HYATTSVILLE, MD 20782-3302
(301) 864-2333
Mailing address
3871 CHAIN BRIDGE RD, FAIRFAX, VA 22030-3903
(818) 731-3576

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
24704
MD

Other

Enumeration date
06/06/2014
Last updated
01/17/2023
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