Provider Demographics
NPI:1396229076
Name:SOMMER, PAMELA KIM (DC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:KIM
Last Name:SOMMER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4333 N 6TH DR APT 509
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-3208
Mailing Address - Country:US
Mailing Address - Phone:818-821-5180
Mailing Address - Fax:
Practice Address - Street 1:8360 E RAINTREE DR STE 135
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2687
Practice Address - Country:US
Practice Address - Phone:480-991-9945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8736111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor