Provider Demographics
NPI:1194760934
Name:SCHIELD, PAMELA LYNNETTE (ATC)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:LYNNETTE
Last Name:SCHIELD
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 STOUT ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-1425
Mailing Address - Country:US
Mailing Address - Phone:304-842-6061
Mailing Address - Fax:304-326-1516
Practice Address - Street 1:223 W MAIN ST
Practice Address - Street 2:CAMPUS BOX 440
Practice Address - City:SALEM
Practice Address - State:WV
Practice Address - Zip Code:26426-1227
Practice Address - Country:US
Practice Address - Phone:304-326-1273
Practice Address - Fax:304-326-1516
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer