Provider Demographics
NPI:1225859754
Name:GASKINS, PAMELA CHRISTINA (LMT)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:CHRISTINA
Last Name:GASKINS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:847 GASKINS HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:WV
Mailing Address - Zip Code:26426-6049
Mailing Address - Country:US
Mailing Address - Phone:304-695-9953
Mailing Address - Fax:
Practice Address - Street 1:1 LOWNDES HILL PARK RD
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26426
Practice Address - Country:US
Practice Address - Phone:304-623-3303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2023-3899225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist