Provider Demographics
NPI:1649393513
Name:MANUS CENTER, PC
Entity Type:Organization
Organization Name:MANUS CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHULER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-242-6363
Mailing Address - Street 1:415 CHURCH ST NE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4742
Mailing Address - Country:US
Mailing Address - Phone:703-242-6363
Mailing Address - Fax:703-242-6368
Practice Address - Street 1:415 CHURCH ST NE
Practice Address - Street 2:SUITE 101
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4742
Practice Address - Country:US
Practice Address - Phone:703-242-6363
Practice Address - Fax:703-242-6368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-07
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0021522872174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA585537Medicare PIN
VA586375M37Medicare PIN
VAI24123Medicare UPIN
VAH48802Medicare UPIN
VA008175M37Medicare PIN
VAE32468Medicare UPIN
VA015932M37Medicare PIN