Provider Demographics
NPI:1508145616
Name:ALSBERRY, PAMELA (PT)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:
Last Name:ALSBERRY
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 1:1816 BENJAMIN BLVD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-6309
Mailing Address - Country:US
Mailing Address - Phone:843-496-5444
Mailing Address - Fax:
Practice Address - Street 1:121 E CEDAR ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2576
Practice Address - Country:US
Practice Address - Phone:843-661-3426
Practice Address - Fax:843-661-3599
Is Sole Proprietor?:No
Enumeration Date:2011-08-07
Last Update Date:2011-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1149225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist