Individual
MR. MARK NOLL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1000 N SHENANDOAH AVE, FRONT ROYAL, VA 22630-3547
(540) 636-0242
Mailing address
156 RAPHAEL CT, MARTINSBURG, WV 25403-3902
(301) 730-7125
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306604885
VA
Other
Enumeration date
10/05/2018
Last updated
10/05/2018
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