Provider Demographics
NPI:1295984151
Name:HILEMAN, PAMELA M (PTA)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:M
Last Name:HILEMAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MISS
Other - First Name:PAMELA
Other - Middle Name:M
Other - Last Name:NORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7201 GREEN BAY RD
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53142-3532
Mailing Address - Country:US
Mailing Address - Phone:262-694-3977
Mailing Address - Fax:262-694-5648
Practice Address - Street 1:7201 GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-3532
Practice Address - Country:US
Practice Address - Phone:262-694-3977
Practice Address - Fax:262-694-5648
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1500-019225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant