Provider Demographics
NPI:1467532242
Name:LATIMER, PAMELA GOLAY (DC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:GOLAY
Last Name:LATIMER
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 1:1599 ORLEANS RD
Mailing Address - Street 2:PO BOX 1484
Mailing Address - City:HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02645-2147
Mailing Address - Country:US
Mailing Address - Phone:508-432-5008
Mailing Address - Fax:508-430-2937
Practice Address - Street 1:1599 ORLEANS RD
Practice Address - Street 2:
Practice Address - City:HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02645-2147
Practice Address - Country:US
Practice Address - Phone:508-432-5008
Practice Address - Fax:508-430-2937
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA900111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALAY35707OtherBLUE CROSS
MA35265OtherHARVARD PILGRIM
MA100322000OtherFEDERAL WORK COMP
MA100322000OtherFEDERAL WORK COMP
MA010442020Medicare UPIN