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1578593943
PAUL JOHN AVERELL
VIRGINIA BEACH, VA
NPI
1578593943
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient
Enumeration Date
2006-07-03
Last Update Date
2007-07-08
Business Address
Mr. PAUL JOHN AVERELL IDC
1550 TOMCAT BLVD
VIRGINIA BEACH, VA 23460
Phone number: 757-314-7198
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Mailing Address
Mr. PAUL JOHN AVERELL IDC
2053 SCHUBERT DR
VIRGINIA BEACH, VA 23454-6644
Phone number: 757-314-7198
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