Keith Loren Mann
Individual provider Active NPI Contractor · Keswick, VA
NPI 1982027488 · NPPES record last updated Feb 4, 2014
Key facts
- NPI
- 1982027488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- Practice address
- 150 Ridgeway Farm Dr
Keswick, VA 22947 - Phone
- (434) 962-1662
- NPI assigned
- Feb 4, 2014
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Timberland Assoc. | Contractor | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Yes |
Addresses
Primary practice location
150 Ridgeway Farm Dr
Keswick, VA 22947
Mailing address
150 Ridgeway Farm Dr
Keswick, VA 22947-3037
Phone (434) 962-1662
Other providers in Keswick, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 4, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.