Individual
MR. JOHN MICHAEL NULTY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
142 S MAIN ST, DANVILLE, VA 24541-2922
(434) 799-2226
Mailing address
212 WINROW DRIVE, JAMESTOWN, NY 27282
(336) 324-3116
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024165660
VA
Other
Enumeration date
12/14/2006
Last updated
07/08/2007
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