Individual
ELIZABETH B KANIANTHRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
8640 SUDLEY ROAD, SUITE 303, MANASSAS, VA 20110-4404
(703) 361-7778
(703) 392-6231
Mailing address
8640 SUDLEY ROAD, SUITE 303, MANASSAS, VA 20110-4404
(703) 361-7778
(703) 392-6231
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110840327
VA
Other
Enumeration date
06/18/2007
Last updated
07/08/2007
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