Provider Demographics
NPI:1003420993
Name:PREISS, KALYN M (DPT)
Entity Type:Individual
Prefix:
First Name:KALYN
Middle Name:M
Last Name:PREISS
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 1:1200 CORPORATE DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242
Mailing Address - Country:US
Mailing Address - Phone:423-206-4158
Mailing Address - Fax:717-773-4654
Practice Address - Street 1:1229 HIGHWAY 42 STE 260
Practice Address - Street 2:
Practice Address - City:PETAL
Practice Address - State:MS
Practice Address - Zip Code:39465-2733
Practice Address - Country:US
Practice Address - Phone:601-909-2925
Practice Address - Fax:601-909-2952
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT6986225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist