Provider Demographics
NPI:1508619677
Name:KAROSEL KENNELS
Entity Type:Organization
Organization Name:KAROSEL KENNELS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SERVICE DOG TRAINER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:MARTYN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-451-8216
Mailing Address - Street 1:16315 TOUCHETTE LN
Mailing Address - Street 2:
Mailing Address - City:FRENCHTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59834-9688
Mailing Address - Country:US
Mailing Address - Phone:650-451-8216
Mailing Address - Fax:
Practice Address - Street 1:16315 TOUCHETTE LN
Practice Address - Street 2:
Practice Address - City:FRENCHTOWN
Practice Address - State:MT
Practice Address - Zip Code:59834-9688
Practice Address - Country:US
Practice Address - Phone:650-451-8216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment