Provider Demographics
NPI:1437350162
Name:WOODS, PAMELA MARIE (PT,DPT)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:MARIE
Last Name:WOODS
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:MS
Other - First Name:PAMELA
Other - Middle Name:MARIE
Other - Last Name:KENNARD-HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:70 SYCAMORE CANYON RD
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-5830
Mailing Address - Country:US
Mailing Address - Phone:310-418-9451
Mailing Address - Fax:
Practice Address - Street 1:70 SYCAMORE CANYON RD
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5830
Practice Address - Country:US
Practice Address - Phone:310-418-9451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 14030225100000X
AZ12667225100000X
GAPT006964225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA511I650322Medicare PIN