Provider Demographics
NPI:1043989007
Name:VEALE, PAMELA R (PT)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:R
Last Name:VEALE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:R
Other - Last Name:ROSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1819 E 19TH ST STE 400
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5427
Mailing Address - Country:US
Mailing Address - Phone:918-744-2476
Mailing Address - Fax:
Practice Address - Street 1:1819 E 19TH ST STE 400
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5427
Practice Address - Country:US
Practice Address - Phone:918-744-2476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-12
Last Update Date:2021-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT1599225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist