Provider Demographics
NPI:1013184332
Name:FLOOD, PAMELA T (PTA)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:T
Last Name:FLOOD
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7469 OSCAR LOOP
Mailing Address - Street 2:
Mailing Address - City:LUCAMA
Mailing Address - State:NC
Mailing Address - Zip Code:27851-9357
Mailing Address - Country:US
Mailing Address - Phone:919-758-8521
Mailing Address - Fax:
Practice Address - Street 1:2401 WAYNE MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-1727
Practice Address - Country:US
Practice Address - Phone:919-736-7093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1484225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant