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Individual

DAVID FALLAVOLLITA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DNAP

Contact information

Practice address
7277 JACKSON AVE, MECHANICSVILLE, VA 23111-1739
(703) 309-8422
Mailing address
249 NORTHUMBERLAND DR, STEPHENSON, VA 22656-1999
(703) 309-8422

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001267539
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024186496
VA

Other

Enumeration date
03/04/2022
Last updated
03/21/2023
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