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General NPI Number Information
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NPI Number | 1104600451
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Entity Type | Organization
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Legal Business Name | PA STAFFING
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Dates
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Enumeration Date | 08/18/2023
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Last Update Date | 08/18/2023
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Provider Practice Location Address
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Address Line | 14561 N OUTER 40 RD
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City | CHESTERFIELD
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State | MO
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Zip | 63017-5703
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Country | US
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Telephone | 314-881-4280
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Fax | 314-881-4296
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Provider Business Mailing Address
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Address Line | 58 VERDANT VIEW MANOR CT
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City | WENTZVILLE
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State | MO
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Zip | 63385-4995
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Country | US
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Telephone | 314-608-9438
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Fax | 636-674-5407
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH GRASSINO
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Credential | DMS
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Telephone | 314-608-9438
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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