Pamela R Kanicki, PTA

NPI #1669749768 in Jamestown, New York

Provider Information

NPI Number: 1669749768
Entity Type: Individual
Name: Pamela R Kanicki, PTA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Nov 18, 2011
Last Updated: Jan 10, 2014

Practice Location

Address: 774 FAIRMOUNT AVE
City: Jamestown
State: New York
ZIP Code: 14701-2609
Phone: (716) 338-0668

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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