Organization
MANCHESTER LAKES MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNETTE JOHN (MANAGER)
(757) 483-7706
Entity
Organization
Contact information
Practice address
7015 E MANCHESTER BLVD, ALEXANDRIA, VA 22310
(757) 483-7706
Mailing address
422 GARRISONVILLE RD, STAFFORD, VA 22554-1573
(540) 658-9340
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
02/19/2008
Last updated
02/21/2008
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