Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 1484 | NC |
NPI | 1013184332 |
---|---|
Provider Name | Pamela T Flood |
First Address | Lucama, NC 27851-9357 |
Second Address | Goldsboro, NC 27534-1727 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2008 |
Last Update Date | 15/05/2008 |