Provider Demographics
NPI:1992902217
Name:MIDDLETON, PAMELA ANN (PT, MPT, MCMT)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:MIDDLETON
Suffix:
Gender:F
Credentials:PT, MPT, MCMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 W F ST
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-1614
Mailing Address - Country:US
Mailing Address - Phone:661-823-3070
Mailing Address - Fax:661-823-3090
Practice Address - Street 1:116 W F ST
Practice Address - Street 2:
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-1614
Practice Address - Country:US
Practice Address - Phone:661-823-3070
Practice Address - Fax:661-823-3090
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT30380225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist