Provider Demographics
NPI:1760710222
Name:SALADINO, PAMELA JEAN (PTA)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:JEAN
Last Name:SALADINO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:JEAN
Other - Last Name:BULLOCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:165 DELTA PINE DR
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35811-7806
Mailing Address - Country:US
Mailing Address - Phone:615-519-9152
Mailing Address - Fax:
Practice Address - Street 1:165 DELTA PINE DR
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35811-7806
Practice Address - Country:US
Practice Address - Phone:615-519-9152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN744225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant