Provider Demographics
NPI:1124180773
Name:MAXWELL, PAMELA (PT)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 RIVERCHASE CTR
Mailing Address - Street 2:BLDG 700, SUITE 705
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35244-2866
Mailing Address - Country:US
Mailing Address - Phone:205-739-7800
Mailing Address - Fax:
Practice Address - Street 1:2200 RIVERCHASE CTR
Practice Address - Street 2:BLDG 700, SUITE 705
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35244-2866
Practice Address - Country:US
Practice Address - Phone:205-739-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH2070225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist