Healthcare Provider Details

I. General information

NPI: 1922395045
Provider Name (Legal Business Name): PAMELA SUE OUZTS L.MT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2011
Last Update Date: 07/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 THONOTOSASSA RD SUITE 2
PLANT CITY FL
33563-4200
US

IV. Provider business mailing address

1801 THONOTOSASSA RD SUITE 2
PLANT CITY FL
33563-4200
US

V. Phone/Fax

Practice location:
  • Phone: 813-752-5943
  • Fax: 813-752-4203
Mailing address:
  • Phone: 813-752-5943
  • Fax: 813-752-4203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173C00000X
TaxonomyReflexologist
License NumberMA18092
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: