Provider Demographics
NPI:1871602672
Name:JOYCE, KENNETH PAUL (PT)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:PAUL
Last Name:JOYCE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:17897 E CINDERCONE RD
Mailing Address - Street 2:
Mailing Address - City:RIO VERDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85263-5386
Mailing Address - Country:US
Mailing Address - Phone:407-902-8178
Mailing Address - Fax:
Practice Address - Street 1:8405 N PIMA CENTER PKWY STE 101
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4669
Practice Address - Country:US
Practice Address - Phone:602-922-9222
Practice Address - Fax:602-889-0569
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-30125225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLPT-30125OtherARIZONA STATE BOARD OF PHYSICAL THERAPY