Most Relevant Information
Provider Data
| NPI Number: | 1003225418 |
| Provider Name: | PAVI ELLE SHANELL POOLE |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 4703113526 |
Most Important Dates
| Enumeration Date: | 08/11/2014 |
| Last Updated: | 08/11/2014 |
Provider Practice Location
16874 AVON AVE
DETROIT
MI
482194143
Practice Location Phone/Fax
| Phone: | 7348372229 |
| Fax: |
Provider Mailing Location
16874 AVON AVE
DETROIT
MI
482194143
Provider Mailing Phone/Fax
| Phone: | 7348372229 |
| Fax: |