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General NPI Number Information
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NPI Number | 1760105803
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Entity Type | Individual
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Provider Name | JANICE GULLAS PABELLANO PT, DPT, GCS
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Gender | Female
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Dates
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Enumeration Date | 09/23/2022
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 400 N PENNSYLVANIA AVE UNIT 101
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City | ROSWELL
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State | NM
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Zip | 88201-4754
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Country | US
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Telephone | 575-623-9101
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 N SYCAMORE AVE APT 209
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City | ROSWELL
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State | NM
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Zip | 88201-8823
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Country | US
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Telephone | 704-691-9773
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 003939
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | GE210258
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT-2025-0171
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License Number State | NM
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