NPI 1780822841

Derrick John Mathis, ALFA

Practitioner Nursing Home Administrator Manassas, VA

Practice location

Address: 9827 Sudley Manor Dr, Manassas, VA 20109-6232
Phone: (703) 530-7751

Registered specialties

Nursing Home Administrator Primary

Nursing Service Related Providers Taxonomy 376G00000X Licence 1706000192 (VA)

Other Nursing Home Administrator providers in Virginia →

Registry record

NPI: 1780822841
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Jan 2009
Record last updated: 28 Jan 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.