PAMELA R. CLACK (NPI# 1053476929) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053476929 |
| Entity Type | Individual |
| Full Name | PAMELA R. CLACK |
| Credential | P.T. |
| Practice Address |
703 Kings Rdg Monroe GA 30655-2051 |
| Mailing Address |
1500 Launius Rd Good Hope GA 30641-2637 |
| Practice Telephone | 7702075788 |
| Practice Fax Number | 7702075708 |
| Mailing Telephone | 7067520779 |
| Mailing Fax Number | 7067521596 |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
001415 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
703 KINGS RDG |
| City | MONROE |
| State | GA |
| Zip Code | 30655-2051 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558968149 | Coresa Hawanis Thomas | Counselor | Advantage Behavioral Health, 384 State Hwy 11 Sw, Walton, GA 30655 | 2020-10-06 |
| 1821629049 | Daniel A Hodges | Dentist | 1190 West Spring St, Suite A, Monroe, GA 30655 | 2020-01-27 |
| 1669019071 | Daniel Bradley Hodges | Dentist | 1190 W. Spring St, Monroe, GA 30655 | 2019-12-04 |
| 1861962730 | Danny Shoemake | Counselor | 2080 Highway 78 Nw, Monroe, GA 30655 | 2018-12-04 |
| 1205329687 | Advantage Behavioral Health Systems | Clinic/Center | 638 Michael Cir., Monroe, GA 30655 | 2018-06-11 |
| 1144722455 | Catherine Williams | Behavioral Analyst | 109 Blaine Street, Monroe, GA 30655 | 2018-03-02 |
| 1588186811 | Francette Dubuche Bernard | Nurse Practitioner | 398 Highway 11, Sw, Monroe, GA 30655 | 2017-07-07 |
| 1437699006 | Amanda Kaye Green | Nurse Practitioner | 517 Great Oaks Drive Suite 103, Monroe, GA 30655 | 2017-03-02 |
| 1639528524 | Matthew Bradford Allgood | Physical Therapist | 2120 W Spring St Ste 1500, Monroe, GA 30655 | 2016-06-10 |
| 1477939221 | Healthy Home Transitions | Social Worker | 506 S Broad Street, Monroe, GA 30655 | 2015-08-04 |
| Find all providers in zip 30655 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417374661 | Yingna Li | Physical Therapist | 2327 Whitney Dr, Monroe, LA 71201-2954 | 2014-03-26 |
| 1780906149 | Deborah J Zimmerman | Physical Therapist | 4405 Sardis Church Road, Childworks Therapy, LLC, Monroe, NC 28110-7998 | 2010-02-25 |
| 1043456247 | Linda Ann Dolansky | Physical Therapist | 66 Sunfish Ln, Monroe, NY 10950-5012 | 2008-12-18 |
| 1811151970 | Susan Rae Rehr | Physical Therapist | 118 Federal Rd, Monroe, NJ 08831-8018 | 2008-07-17 |
| 1568679017 | All About Kids LLC | Physical Therapist | 48 Poplar Dr, Monroe, NY 10950-1015 | 2007-05-16 |
| 1871732156 | Carolyn Mercer Bowers | Physical Therapist | 4405 Sardis Church Rd, Childworks Therapy, LLC, Monroe, NC 28110 | 2009-02-11 |
| 1558507566 | Yehudit Leora Herskovich | Physical Therapist | 1 Dinev Ct, Monroe, NY 10950-6449 | 2008-12-22 |
| 1730325903 | Dina Quiles | Physical Therapist | 1 Dinev Ct, Monroe, NY 10950-6449 | 2008-12-18 |
| 1649416819 | Debora Baum- Kupfer | Physical Therapist | 6 Dinev Ct, Monroe, NY 10950-6326 | 2008-12-18 |
| 1659521516 | Noreen Theresa Mahon | Physical Therapist | 48 Poplar Dr, Monroe, NY 10950-1015 | 2008-09-26 |
| Find all providers in MONROE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.