Provider Demographics
NPI:1649338229
Name:HIBBS, PAMELA ANN
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:ANN
Last Name:HIBBS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 WOODLYN DRIVE
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19053
Mailing Address - Country:US
Mailing Address - Phone:215-357-0697
Mailing Address - Fax:
Practice Address - Street 1:ONE GREENWOOD SQUARE SUITE 320
Practice Address - Street 2:3333 STREET ROAD
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020
Practice Address - Country:US
Practice Address - Phone:215-638-3597
Practice Address - Fax:215-638-7430
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA164282251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic