Provider Demographics
NPI:1255851754
Name:PERRY, KARLEY LYNN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KARLEY
Middle Name:LYNN
Last Name:PERRY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KARLEY
Other - Middle Name:LYNN
Other - Last Name:KILE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:6397 LEE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2564
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:225 N MOONLIGHT RD
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:KS
Practice Address - Zip Code:66030-1928
Practice Address - Country:US
Practice Address - Phone:913-856-7927
Practice Address - Fax:913-856-8442
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-05722225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist