Provider Demographics
NPI:1578522645
Name:WOODHEAD, PAMELA (PT)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:
Last Name:WOODHEAD
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 1:823 W MINOT RD
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ME
Mailing Address - Zip Code:04258-5446
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:823 W MINOT RD
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ME
Practice Address - Zip Code:04258-5446
Practice Address - Country:US
Practice Address - Phone:207-966-2345
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEME264943225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist