Individual
DR. CARROLL JOHN NICKLE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1224 CHATTINGHAM DR, VIRGINIA BEACH, VA 23464-5836
(757) 495-2719
Mailing address
1224 CHATTINGHAM DR, VIRGINIA BEACH, VA 23464-5836
(757) 495-2719
Taxonomy
Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
Primary
19464
CO
Other
Enumeration date
08/12/2005
Last updated
07/08/2007
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