Individual
MR. NICK R AVILA III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
372 LIVE OAK LN, GALAX, VA 24333-5476
(276) 238-7100
(276) 238-0024
Mailing address
372 LIVE OAK LN, GALAX, VA 24333-5476
(276) 238-7100
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
10/23/2020
Last updated
10/23/2020
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