Provider Demographics
NPI:1598779928
Name:RICE, DENISE LEACH (PT)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:LEACH
Last Name:RICE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:DENISE
Other - Last Name:LEACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:8400 PINE TREE LN
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7850
Mailing Address - Country:US
Mailing Address - Phone:561-547-8856
Mailing Address - Fax:561-547-6521
Practice Address - Street 1:3375 BURNS RD
Practice Address - Street 2:#104
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4349
Practice Address - Country:US
Practice Address - Phone:561-624-1719
Practice Address - Fax:561-625-0768
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2237225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE6104AMedicare ID - Type UnspecifiedPHYSICAL THERAPY