Individual
MAX MANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11150 FAIRFAX BLVD STE 502, FAIRFAX, VA 22030-5066
(571) 422-3927
Mailing address
610 S EATON ST, BALTIMORE, MD 21224-4307
Taxonomy
Speciality
Code
Description
License number
State
2255R0406X
Blind Rehabilitation Specialist/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007953781
AETNA
—
Enumeration date
02/04/2022
Last updated
02/04/2022
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