Provider Demographics
NPI:1316611338
Name:NACE, JESSICA RENEE (DPT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:RENEE
Last Name:NACE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 ESTEN RD
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-2244
Mailing Address - Country:US
Mailing Address - Phone:267-374-4364
Mailing Address - Fax:
Practice Address - Street 1:12 LUTHERAN HOME DR
Practice Address - Street 2:
Practice Address - City:TELFORD
Practice Address - State:PA
Practice Address - Zip Code:18969-1728
Practice Address - Country:US
Practice Address - Phone:215-723-9819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-03
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT029696225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist