Provider Demographics
NPI:1073375085
Name:FLORENCE, PAMELA STROTHER
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:STROTHER
Last Name:FLORENCE
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 1:32 S 11TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62220-1817
Mailing Address - Country:US
Mailing Address - Phone:910-918-4968
Mailing Address - Fax:
Practice Address - Street 1:2727 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63103-1421
Practice Address - Country:US
Practice Address - Phone:314-250-9815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist