Provider Demographics
NPI:1790759710
Name:HOWARD, PAMELA C (PT)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:C
Last Name:HOWARD
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 1:419 TOWN MOUNTAIN RD STE 108
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-1632
Mailing Address - Country:US
Mailing Address - Phone:606-432-8782
Mailing Address - Fax:606-432-8858
Practice Address - Street 1:419 TOWN MOUNTAIN RD STE 108
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1632
Practice Address - Country:US
Practice Address - Phone:606-432-8782
Practice Address - Fax:606-432-8858
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY701225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000068787OtherANTHEM
WV1054493OtherBRICKSTREET
KY000000068787OtherANTHEM