Provider Demographics
NPI:1114638483
Name:STAGGS, KAILEY WILLCUTT (LPTA)
Entity Type:Individual
Prefix:MRS
First Name:KAILEY
Middle Name:WILLCUTT
Last Name:STAGGS
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:KAILEY
Other - Middle Name:GRACE
Other - Last Name:WILLCUTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPTA
Mailing Address - Street 1:314 OLD WAGON RD
Mailing Address - Street 2:
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35125-2448
Mailing Address - Country:US
Mailing Address - Phone:205-532-9430
Mailing Address - Fax:
Practice Address - Street 1:400 UNIVERSITY PARK DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6784
Practice Address - Country:US
Practice Address - Phone:659-903-4513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant