Individual
JONATHAN XAVIER KIEMEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6136 BRANDON AVE, SPRINGFIELD, VA 22150-2610
(703) 866-3131
Mailing address
6136 BRANDON AVE, SPRINGFIELD, VA 22150-2610
(703) 866-3131
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110008105
VA
Other
Enumeration date
06/28/2021
Last updated
09/10/2021
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