Individual
MICHAEL JOHN NOLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
310 PINE HILL, PINE HILL, NM 87357
(505) 775-3271
Mailing address
PO BOX 22, PINEHILL, NM 87357-0022
(505) 775-3271
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
104205
NC
Other
Enumeration date
05/29/2007
Last updated
07/08/2007
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