Provider Demographics
NPI:1225000763
Name:KUTELLA, PAMELA JEANNE (LAT)
Entity Type:Individual
Prefix:MISS
First Name:PAMELA
Middle Name:JEANNE
Last Name:KUTELLA
Suffix:
Gender:F
Credentials:LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ANDOVER RD.
Mailing Address - Street 2:APT. E-4
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701
Mailing Address - Country:US
Mailing Address - Phone:740-707-2238
Mailing Address - Fax:
Practice Address - Street 1:OHIO UNIVERSITY
Practice Address - Street 2:GROVER CENTER E207
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701
Practice Address - Country:US
Practice Address - Phone:740-707-2238
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer