Individual
NICHOLAS VINCENT DIGIOVANNANTONIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 LAKESIDE DR, LYNCHBURG, VA 24501-3113
(434) 544-8876
Mailing address
114 COLONNADE ST, LYNCHBURG, VA 24502-5182
(434) 544-8876
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110008823
VA
363A00000X
Physician Assistant
Primary
4848
SC
Other
Enumeration date
04/11/2022
Last updated
08/24/2023
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