Provider Demographics
NPI:1326370495
Name:VOORHEES, PANNEE LAOSURASOONTORN (PT)
Entity type:Individual
Prefix:
First Name:PANNEE
Middle Name:LAOSURASOONTORN
Last Name:VOORHEES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:PANNEE
Other - Middle Name:
Other - Last Name:LAOSURASOONTORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:8720 EMGE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-3504
Mailing Address - Country:US
Mailing Address - Phone:410-688-1961
Mailing Address - Fax:
Practice Address - Street 1:8720 EMGE RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-3504
Practice Address - Country:US
Practice Address - Phone:410-688-1961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23109225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist