Provider Demographics
NPI:1467885574
Name:LUAN-ZAEHLER, PAMELA (HHP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:LUAN-ZAEHLER
Suffix:
Gender:F
Credentials:HHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 SUPERIOR AVE
Mailing Address - Street 2:
Mailing Address - City:TOMAH
Mailing Address - State:WI
Mailing Address - Zip Code:54660-2045
Mailing Address - Country:US
Mailing Address - Phone:608-387-9869
Mailing Address - Fax:
Practice Address - Street 1:702 SUPERIOR AVE
Practice Address - Street 2:
Practice Address - City:TOMAH
Practice Address - State:WI
Practice Address - Zip Code:54660-2045
Practice Address - Country:US
Practice Address - Phone:608-387-9869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5018-146225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist