Provider Demographics
NPI:1164632634
Name:CHLAD, PAMELA SUE (ATC,RN)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:SUE
Last Name:CHLAD
Suffix:
Gender:F
Credentials:ATC,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 HUNSICKER DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-2665
Mailing Address - Country:US
Mailing Address - Phone:610-409-0406
Mailing Address - Fax:610-409-3776
Practice Address - Street 1:601 EAST MAIN STREET
Practice Address - Street 2:URSINUS COLLEGE
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-1000
Practice Address - Country:US
Practice Address - Phone:610-409-3000
Practice Address - Fax:610-409-3776
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART000169A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer