Basic Information
Provider Information
NPI: 1518216019
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KAYS
FirstName: PAMELA
MiddleName: V
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9097 E DESERT COVE AVE STE 110
Address2:  
City: SCOTTSDALE
State: AZ
PostalCode: 852606276
CountryCode: US
TelephoneNumber: 4805514967
FaxNumber: 4808600356
Practice Location
Address1: 16611 S 40TH ST STE 130
Address2:  
City: PHOENIX
State: AZ
PostalCode: 85048
CountryCode: US
TelephoneNumber: 4807061199
FaxNumber: 4807063999
Other Information
ProviderEnumerationDate: 08/30/2012
LastUpdateDate: 02/24/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/24/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X9947AZY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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