Healthcare Provider Details
I. General information
NPI: 1922761261
Provider Name (Legal Business Name): MR. FRANK PAUL MILITELLO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/13/2021
Last Update Date: 10/13/2021
Certification Date: 10/13/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9600 VETERANS DR SW
TACOMA WA
98493-0003
US
IV. Provider business mailing address
4275 S PINE ST APT A311
TACOMA WA
98409-6580
US
V. Phone/Fax
- Phone: 253-583-1221
- Fax:
- Phone: 231-250-3622
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2255R0406X |
| Taxonomy | Blind Rehabilitation Specialist/Technologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: