Provider Demographics
NPI:1740405349
Name:SCARBROUGH, PAMELA JEANETTE (PTA)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:JEANETTE
Last Name:SCARBROUGH
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1614 E PEARLY SMITH RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37777
Mailing Address - Country:US
Mailing Address - Phone:865-789-7739
Mailing Address - Fax:865-691-8346
Practice Address - Street 1:9000 EXECUTIVE PARK DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923
Practice Address - Country:US
Practice Address - Phone:865-539-0242
Practice Address - Fax:865-691-8346
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1895225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant