Provider Demographics
NPI:1922050681
Name:GATEWOOD, PAMELA S (PT)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:S
Last Name:GATEWOOD
Suffix:
Gender:F
Credentials:PT
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Mailing Address - Street 1:6612 S WARD ST
Mailing Address - Street 2:200
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-4855
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:290 NICKEL ST
Practice Address - Street 2:200
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-2183
Practice Address - Country:US
Practice Address - Phone:303-460-9151
Practice Address - Fax:303-460-7443
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2016-06-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO8592225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC803857Medicare PIN