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General NPI Number Information
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NPI Number | 1437109006
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Entity Type | Individual
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Provider Name | JUDITH K PENCE PT
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Gender | Female
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 10/24/2019
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Provider Practice Location Address
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Address Line | 285 8TH ST S
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City | NAPLES
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State | FL
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Zip | 34102-6123
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Country | US
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Telephone | 239-331-4460
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Fax | 239-331-4437
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Provider Business Mailing Address
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Address Line | 6335 SCORPIO AVE
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City | NORTH PORT
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State | FL
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Zip | 34287-2233
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Country | US
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Telephone | 239-272-3674
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT5774
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License Number State | FL
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