South Boston Pediatrics, PC
NPI #1356690366 in South Boston, Virginia
Provider Information
- NPI Number
- 1356690366
- Entity Type
- Organization
- Organization Name
- South Boston Pediatrics, PC
- Primary Specialty
- Pediatrics
- Enumeration Date
- Sep 5, 2012
- Last Updated
- Sep 5, 2012
Practice Location
- Address
- 2202 BEECHMONT RD
- City
- South Boston
- State
- Virginia
- ZIP Code
- 24592-1614
- Phone
- (434) 572-3635
Authorized Official
- Name
- DR. NONNA LYN EBALO, M.D.
- Title
- PRESIDENT
- Phone
- (434) 470-3489
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pediatrics |
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