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General NPI Number Information
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NPI Number | 1730473489
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Entity Type | Organization
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Legal Business Name | PAWSABILITIES
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Dates
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Enumeration Date | 05/30/2011
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Last Update Date | 05/30/2011
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Provider Practice Location Address
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Address Line | 2505 S RUSSELL ST
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City | MISSOULA
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State | MT
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Zip | 59801-7979
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Country | US
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Telephone | 406-728-9288
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Fax |
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Provider Business Mailing Address
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Address Line | 256 SEASIDE DR
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City | PACIFICA
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State | CA
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Zip | 94044-2930
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Country | US
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Telephone | 650-898-9117
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. DONALD GLENN MARTYN
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Credential |
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Telephone | 650-898-9117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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