Individual
PAULA HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5034 COAKLEY CIRCLE, MARIPOSA, CA 95338
(209) 742-6224
(209) 966-7848
Mailing address
PO BOX 1913, MARIPOSA, CA 95338-1913
(209) 742-6162
(209) 742-6163
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
100458
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME00572F
—
CA
Enumeration date
07/14/2006
Last updated
09/03/2013
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