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Derrick John Mathis, ALFA
Nursing Home Administrator in Manassas, Virginia
NPI 1780822841

Derrick John Mathis is a Nursing Home Administrator based in Manassas, VA. Derrick John Mathis practices in Manassas, VA and has the professional credentials of ALFA. The NPI Number for Derrick John Mathis is 1780822841 and holds a License No. 1706000192 (Virginia).

The current practice location address for Derrick John Mathis is 9827 Sudley Manor Dr, Manassas, VA and can be reached out via phone at 703-530-7751.

Location: 9827 Sudley Manor Dr, Manassas, VA, 20109-6232
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1780822841
Provider Name
Derrick John Mathis
Credential
ALFA
Provider Entity Type
Individual
Gender
Male
Address
9827 Sudley Manor Dr, Manassas, VA, 20109-6232
Phone Number
703-530-7751
Fax Number
Provider Enumeration Date
01/28/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
9827 Sudley Manor Dr
City
Manassas
State
Virginia
Zip
20109-6232
Phone Number
703-530-7751
Fax Number
person
Provider Business Mailing Address Details
Address
9827 Sudley Manor Dr
City
Manassas
State
Virginia
Zip
20109-6232
Phone Number
703-530-7751
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Related Providers
Classification
Nursing Home Administrator
Speciality
-
Taxonomy
376G00000X
License No.
1706000192 (Virginia)
Definition
An individual, often licensed by the state, who is responsible for the management of a nursing home.
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