Provider Demographics
NPI:1952527053
Name:SEIDLER, PAMELA (PT)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:
Last Name:SEIDLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 A AIRPORT BUSINESS CENTER
Mailing Address - Street 2:
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611
Mailing Address - Country:US
Mailing Address - Phone:970-920-1070
Mailing Address - Fax:970-920-1071
Practice Address - Street 1:303 ABC
Practice Address - Street 2:SUITE A
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-3531
Practice Address - Country:US
Practice Address - Phone:970-920-1070
Practice Address - Fax:970-920-1071
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6457225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist