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General NPI Number Information
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NPI Number | 1104865245
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Entity Type | Individual
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Provider Name | JOSEPH V. POOLE I AIDE,CARE GIVER
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Gender | Male
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 2076A MAPLE BENNER RD
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City | PORTSMOUTH
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State | OH
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Zip | 45662-8831
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Country | US
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Telephone | 740-353-2305
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Fax |
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Provider Business Mailing Address
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Address Line | 2076 MAPLE BENNER RD
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City | PORTSMOUTH
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State | OH
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Zip | 45662-8831
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Country | US
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Telephone | 740-353-2305
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | 2451789
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License Number State | OH
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