Provider Demographics
NPI:1306049879
Name:RITZLINE, PAMELA D
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:D
Last Name:RITZLINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 MADISON AVE
Mailing Address - Street 2:SUITE 640
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38163-2243
Mailing Address - Country:US
Mailing Address - Phone:901-448-5888
Mailing Address - Fax:901-448-1411
Practice Address - Street 1:930 MADISON AVE
Practice Address - Street 2:SUITE 640
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38163-2243
Practice Address - Country:US
Practice Address - Phone:901-448-5888
Practice Address - Fax:901-448-1411
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7752225100000X
IN05004551A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist