Provider Demographics
NPI:1649562646
Name:FELTENBERGER, PAMELA
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:FELTENBERGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2760 LAKE SAHARA DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-3438
Mailing Address - Country:US
Mailing Address - Phone:702-222-0792
Mailing Address - Fax:
Practice Address - Street 1:2760 LAKE SAHARA DR
Practice Address - Street 2:SUITE 108
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-3438
Practice Address - Country:US
Practice Address - Phone:702-222-0792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner