Provider Demographics
NPI:1487675484
Name:PAMELA HARRIS, P.T., INC.
Entity Type:Organization
Organization Name:PAMELA HARRIS, P.T., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:317-691-6486
Mailing Address - Street 1:651 BROOKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-1802
Mailing Address - Country:US
Mailing Address - Phone:317-691-6486
Mailing Address - Fax:317-883-4815
Practice Address - Street 1:651 BROOKVIEW DR
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-1802
Practice Address - Country:US
Practice Address - Phone:317-691-6486
Practice Address - Fax:317-883-4815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05005045A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty