Provider Demographics
NPI:1114999620
Name:SINGLETARY, PAMELA K (P T)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:K
Last Name:SINGLETARY
Suffix:
Gender:F
Credentials:P T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 S COTTONWOOD ST
Mailing Address - Street 2:
Mailing Address - City:BUNKIE
Mailing Address - State:LA
Mailing Address - Zip Code:71322-1135
Mailing Address - Country:US
Mailing Address - Phone:318-346-2682
Mailing Address - Fax:318-346-7315
Practice Address - Street 1:510 SOUTH COTTONWOOD ST.
Practice Address - Street 2:
Practice Address - City:BUNKIE
Practice Address - State:LA
Practice Address - Zip Code:71322-0958
Practice Address - Country:US
Practice Address - Phone:318-346-2682
Practice Address - Fax:318-346-7315
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA00503225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5X721Medicare ID - Type Unspecified