Provider Demographics
NPI:1083906929
Name:HYLTON, PAUL (ATC)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:HYLTON
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 CLARENDON CIR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-2625
Mailing Address - Country:US
Mailing Address - Phone:434-250-4801
Mailing Address - Fax:
Practice Address - Street 1:135 CLARENDON CIR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-2625
Practice Address - Country:US
Practice Address - Phone:434-250-4801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0126000807174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist