Provider Demographics
NPI:1679793251
Name:DUFFY, PAMELA ANN (PT)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:ANN
Last Name:DUFFY
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 1:2833 J AVE
Mailing Address - Street 2:
Mailing Address - City:ADEL
Mailing Address - State:IA
Mailing Address - Zip Code:50003-8260
Mailing Address - Country:US
Mailing Address - Phone:515-299-5859
Mailing Address - Fax:515-299-5828
Practice Address - Street 1:2833 J AVE
Practice Address - Street 2:
Practice Address - City:ADEL
Practice Address - State:IA
Practice Address - Zip Code:50003-8260
Practice Address - Country:US
Practice Address - Phone:515-299-5859
Practice Address - Fax:515-299-5828
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA10602251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic