Individual
KEVIN MINNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11132 STONEBROOK DR, MANASSAS, VA 20112-3050
(703) 987-8401
Mailing address
11132 STONEBROOK DR, MANASSAS, VA 20112-3050
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119007257
VA
Other
Enumeration date
03/07/2017
Last updated
03/07/2017
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