Provider Demographics
NPI:1215093711
Name:PASLEY, ETHEL LEE
Entity type:Individual
Prefix:MS
First Name:ETHEL
Middle Name:LEE
Last Name:PASLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 PANORAMA CT
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29611-7621
Mailing Address - Country:US
Mailing Address - Phone:864-269-6692
Mailing Address - Fax:
Practice Address - Street 1:103 PANORAMA CT
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29611-7621
Practice Address - Country:US
Practice Address - Phone:864-269-6692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC023016326332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies