Individual
ZACHARY TAYLOR VANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSA/LSA
Contact information
Practice address
13710 ST FRANCIS BLVD, MIDLOTHIAN, VA 23114-3267
(804) 594-3050
Mailing address
8104 FOXCATCHER CT, NORTH CHESTERFIELD, VA 23235-6544
(577) 968-8387
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
0136000367
VA
Other
Enumeration date
08/19/2021
Last updated
08/19/2021
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