Provider Demographics
NPI:1457470460
Name:ELSKE-LEONETTI, PAMELA SUE (PT)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:SUE
Last Name:ELSKE-LEONETTI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:PAM
Other - Middle Name:
Other - Last Name:ELSKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2862 20TH ST NE
Mailing Address - Street 2:HICKORY
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-9184
Mailing Address - Country:US
Mailing Address - Phone:336-613-0426
Mailing Address - Fax:
Practice Address - Street 1:420 N CENTER ST
Practice Address - Street 2:HICKORY
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-5033
Practice Address - Country:US
Practice Address - Phone:828-315-3619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10749225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist