Provider Demographics
NPI:1700824687
Name:WINSOR, PAMELA (PT)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:
Last Name:WINSOR
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 1:1068 MAIN ST
Mailing Address - Street 2:BOX 11
Mailing Address - City:SANFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04073-3606
Mailing Address - Country:US
Mailing Address - Phone:207-324-6811
Mailing Address - Fax:207-324-6811
Practice Address - Street 1:1068 MAIN ST
Practice Address - Street 2:BOX 11
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073-3606
Practice Address - Country:US
Practice Address - Phone:207-324-6811
Practice Address - Fax:207-324-6811
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT8742251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME043193OtherANTHEM