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Individual

PAMELA ISABEL TAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA, LMT

Contact information

Practice address
19580 HIGHLAND OAKS DR APT 103, ESTERO, FL 33928-9621
(847) 373-0921
Mailing address
19580 HIGHLAND OAKS DR APT 103, ESTERO, FL 33928-9621
(847) 373-0921

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA27199
FL
225700000X
Massage Therapist
MA82366
FL

Other

Enumeration date
12/09/2020
Last updated
01/06/2021
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