Individual
KEITH MANESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
161 UPSAL ST SE, WASHINGTON, DC 20032-2401
(301) 925-4480
Mailing address
9726 OXBRIDGE WAY, BOWIE, MD 20721-3119
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
70899405
—
DC
Enumeration date
10/26/2017
Last updated
10/26/2017
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