Provider Demographics
NPI:1487638565
Name:HARTSHORN, PAMELA C (PT)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:C
Last Name:HARTSHORN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 WISEBECKER LN
Mailing Address - Street 2:
Mailing Address - City:MONONGAHELA
Mailing Address - State:PA
Mailing Address - Zip Code:15063-1144
Mailing Address - Country:US
Mailing Address - Phone:724-258-7976
Mailing Address - Fax:
Practice Address - Street 1:998 MAIN ST
Practice Address - Street 2:
Practice Address - City:BENTLEYVILLE
Practice Address - State:PA
Practice Address - Zip Code:15314-1100
Practice Address - Country:US
Practice Address - Phone:724-239-5777
Practice Address - Fax:724-239-3036
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT002514225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist