Provider Demographics
NPI:1770765018
Name:PENDERS, KALI NICOLE (DPT)
Entity type:Individual
Prefix:MRS
First Name:KALI
Middle Name:NICOLE
Last Name:PENDERS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:KALI
Other - Middle Name:NICOLE
Other - Last Name:SAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1506A ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01118-1817
Mailing Address - Country:US
Mailing Address - Phone:413-783-5500
Mailing Address - Fax:
Practice Address - Street 1:1506A ALLEN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01118-1817
Practice Address - Country:US
Practice Address - Phone:413-783-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA179522251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics