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NPI Code Detail

MEDICARE: PAMELA A. WOODHURST M.S.P.T.

MEDICARE:   PAMELA A. WOODHURST  M.S.P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251P0200XPediatric Physical Therapist3736AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1425943OTHERAZAHCCCS

General Provider Information

NPI Number : 1710025770
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA A. WOODHURST M.S.P.T.
Provider Business Mailing Address
First Line : 1055 E PRESCOTT PL
Second Line :
City : CHANDLER
State : AZ
Zip : 85249-2833
Country : US
Telephone Number : 480-510-2648
Fax Number :
Provider Business Practice Location Address
First Line : 1625 E FRYE RD
Second Line :
City : CHANDLER
State : AZ
Zip : 85225-5114
Country : US
Telephone Number : 480-883-4081
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2007
Last Update Date : 07/08/2007

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Directions to “ PAMELA A. WOODHURST M.S.P.T.” Practice Location

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