Individual
NICOLE JULIETTE COLGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1860 TOWN CENTER DR, STE 335, RESTON, VA 20190-5900
(703) 787-3322
(703) 787-3380
Mailing address
1860 TOWN CENTER DR, STE 335, RESTON, VA 20190-5900
(703) 787-3322
(703) 787-3380
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
0101266532
VA
Other
Enumeration date
06/23/2014
Last updated
02/01/2021
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