Provider Demographics
NPI:1104897768
Name:DENCH, TIMOTH (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MR
First Name:TIMOTH
Middle Name:
Last Name:DENCH
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16413 BRIDGELAWN AVE
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-4849
Mailing Address - Country:US
Mailing Address - Phone:813-829-9009
Mailing Address - Fax:863-299-3836
Practice Address - Street 1:950 1ST ST S
Practice Address - Street 2:SUITE 202
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-3665
Practice Address - Country:US
Practice Address - Phone:863-293-7778
Practice Address - Fax:863-299-3836
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00724500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist