Provider Demographics
NPI:1942367594
Name:LEIF, PAMELA S (CHIROPRACTOR)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:S
Last Name:LEIF
Suffix:
Gender:F
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2269 S UNIVERSITY DR
Mailing Address - Street 2:#139
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-5856
Mailing Address - Country:US
Mailing Address - Phone:954-701-7001
Mailing Address - Fax:
Practice Address - Street 1:2269 S UNIVERSITY DR
Practice Address - Street 2:#139
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33324-5856
Practice Address - Country:US
Practice Address - Phone:954-701-7001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH5450111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor