Provider Demographics
NPI:1336558758
Name:PEMBERTON, DEVIN MARIE (DPT)
Entity Type:Individual
Prefix:DR
First Name:DEVIN
Middle Name:MARIE
Last Name:PEMBERTON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:DEVIN
Other - Middle Name:MARIE
Other - Last Name:HUGHEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1302 PIAZZA DELLE PALLOTTOLE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8274
Mailing Address - Country:US
Mailing Address - Phone:386-871-5288
Mailing Address - Fax:561-432-1075
Practice Address - Street 1:6169 S JOG RD
Practice Address - Street 2:SUITE A11
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-6579
Practice Address - Country:US
Practice Address - Phone:561-432-0111
Practice Address - Fax:561-432-1075
Is Sole Proprietor?:No
Enumeration Date:2014-08-11
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist