Healthcare Provider Details

I. General information

NPI: 1477942175
Provider Name (Legal Business Name): PAMELA SCHAETTE-FOWLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2015
Last Update Date: 01/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3571 CARTHAGE RD
WEST END NC
27376-8336
US

IV. Provider business mailing address

PO BOX 354
WEST END NC
27376-0354
US

V. Phone/Fax

Practice location:
  • Phone: 910-673-5437
  • Fax: 910-673-5438
Mailing address:
  • Phone: 910-673-5437
  • Fax: 910-673-5438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number9396
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: