Individual
PAMELA ANN BANES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
(800) 517-6935
Mailing address
PO BOX 1156, RAYMOND, MS 39154-1156
(601) 857-8445
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA1824
MS
Other
Enumeration date
04/17/2007
Last updated
07/08/2007
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