Provider Demographics
NPI:1124527999
Name:PAMMER, PAUL (DC)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:PAMMER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CATASAUQUA
Mailing Address - State:PA
Mailing Address - Zip Code:18032-2210
Mailing Address - Country:US
Mailing Address - Phone:610-264-3344
Mailing Address - Fax:
Practice Address - Street 1:1104 6TH ST
Practice Address - Street 2:
Practice Address - City:CATASAUQUA
Practice Address - State:PA
Practice Address - Zip Code:18032-2210
Practice Address - Country:US
Practice Address - Phone:610-264-3344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-07
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011347111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor