Provider Demographics
NPI:1255625604
Name:SPENCE, GAIL H (PT)
Entity type:Individual
Prefix:MS
First Name:GAIL
Middle Name:H
Last Name:SPENCE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2845 CHANCELLOR DR
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3418
Mailing Address - Country:US
Mailing Address - Phone:859-426-5888
Mailing Address - Fax:859-426-0059
Practice Address - Street 1:1400 GLORIA TERRELL DR
Practice Address - Street 2:SUITE G
Practice Address - City:HIGHLAND HEIGHTS
Practice Address - State:KY
Practice Address - Zip Code:41076-9188
Practice Address - Country:US
Practice Address - Phone:859-781-2800
Practice Address - Fax:859-781-3500
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY000694225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK005451Medicare PIN