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Individual

MR. KELVIN MANURS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PRS

Contact information

Practice address
8220 RUSSELL RD, ALEXANDRIA, VA 22309-8218
(571) 245-4568
Mailing address
8220 RUSSELL RD, ALEXANDRIA, VA 22309-8218
(571) 245-4568

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
0735000416
VA
175T00000X
Peer Specialist

Other

Enumeration date
04/05/2022
Last updated
04/29/2022
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