Provider Demographics
NPI:1235140948
Name:KESSANS, KARA MICHELLE (PT, DPT, ATC, CSCS)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:MICHELLE
Last Name:KESSANS
Suffix:
Gender:F
Credentials:PT, DPT, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4435 SHINING ARMOR LN
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906-7138
Mailing Address - Country:US
Mailing Address - Phone:765-413-5671
Mailing Address - Fax:
Practice Address - Street 1:900 JOHN R WOODEN DRIVE
Practice Address - Street 2:MACKEY ARENA
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47907-2070
Practice Address - Country:US
Practice Address - Phone:765-494-3245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05008981A225100000X
IN36001292A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer