Provider Demographics
NPI:1760218291
Name:PANGBORN, ADAM MICHAEL (DPT)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:MICHAEL
Last Name:PANGBORN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21860 ROUTE 6
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:PA
Mailing Address - Zip Code:16365-7950
Mailing Address - Country:US
Mailing Address - Phone:814-688-7157
Mailing Address - Fax:
Practice Address - Street 1:3266 FLUVANNA AVENUE EXT
Practice Address - Street 2:
Practice Address - City:FLUVANNA
Practice Address - State:NY
Practice Address - Zip Code:14701-9706
Practice Address - Country:US
Practice Address - Phone:716-708-6179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist