Provider Demographics
NPI:1033550595
Name:TERRANOVA, PAMELA JOYCE WOODWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:JOYCE WOODWARD
Last Name:TERRANOVA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:PAMELA
Other - Middle Name:JOYCE
Other - Last Name:WOODWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1501 SULGRAVE AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-3651
Mailing Address - Country:US
Mailing Address - Phone:443-869-3626
Mailing Address - Fax:443-869-5548
Practice Address - Street 1:1501 SULGRAVE AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-3654
Practice Address - Country:US
Practice Address - Phone:443-869-3626
Practice Address - Fax:443-869-5548
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009127111N00000X
MDS03756111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor