Provider Demographics
NPI:1912152836
Name:PETERS, JOYCE M (PT)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:M
Last Name:PETERS
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 1:11705 PINTAIL CT
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-8900
Mailing Address - Country:US
Mailing Address - Phone:978-502-2302
Mailing Address - Fax:239-596-1925
Practice Address - Street 1:11705 PINTAIL CT
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-8900
Practice Address - Country:US
Practice Address - Phone:978-502-2302
Practice Address - Fax:239-596-1925
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-19
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT23083225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist