Provider Demographics
NPI:1841213410
Name:LEVINSON, PAMELA L (DC)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:L
Last Name:LEVINSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:646 PORTAGE TRAIL
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221
Mailing Address - Country:US
Mailing Address - Phone:330-928-3420
Mailing Address - Fax:330-928-1110
Practice Address - Street 1:646 PORTAGE TRL
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-3034
Practice Address - Country:US
Practice Address - Phone:330-928-3420
Practice Address - Fax:330-928-1110
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2594111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2047047Medicaid
OH2047047Medicaid