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General NPI Number Information
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NPI Number | 1427865419
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Entity Type | Individual
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Provider Name | MR. DONALD PATRICK PASCOE
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Gender | Male
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Dates
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Enumeration Date | 12/13/2024
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 34643 KETSIN DR
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City | STERLING HEIGHTS
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State | MI
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Zip | 48310-5235
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Country | US
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Telephone | 586-978-2280
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Fax |
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Provider Business Mailing Address
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Address Line | 15800 CANDLE DR
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City | MACOMB
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State | MI
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Zip | 48042-2232
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Country | US
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Telephone | 586-709-2277
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 5502004609
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License Number State | MI
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