Provider Demographics
NPI:1083982946
Name:CARLETON, PAMELA LEIGH
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:LEIGH
Last Name:CARLETON
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 1:200 E ALBERTA ST
Mailing Address - Street 2:
Mailing Address - City:MC LOUTH
Mailing Address - State:KS
Mailing Address - Zip Code:66054-4201
Mailing Address - Country:US
Mailing Address - Phone:913-796-6437
Mailing Address - Fax:
Practice Address - Street 1:200 E ALBERTA ST
Practice Address - Street 2:
Practice Address - City:MC LOUTH
Practice Address - State:KS
Practice Address - Zip Code:66054-4201
Practice Address - Country:US
Practice Address - Phone:913-796-6437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant