Individual
NICHOLAS ROBERT HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2210 WILBORN AVE, SOUTH BOSTON, VA 24592-1630
(434) 575-5864
Mailing address
9400 WEATHERSFIELD DR, BRISTOW, VA 20136-1716
(703) 973-2240
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
01/04/2012
Last updated
01/04/2012
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