Individual
KENNETH D PAVAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTA
Contact information
Practice address
863 HATHAWAY RD, NEW BEDFORD, MA 02740-1916
(508) 996-6763
Mailing address
17 ADIRONDACK LN, WESTPORT, MA 02790-3311
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
00376
RI
224Z00000X
Occupational Therapy Assistant
Primary
3001
MA
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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