Provider Demographics
NPI:1326336579
Name:DAWSON, CASSIE (PT,DPT,SCS,ATC,CSCS)
Entity Type:Individual
Prefix:
First Name:CASSIE
Middle Name:
Last Name:DAWSON
Suffix:
Gender:F
Credentials:PT,DPT,SCS,ATC,CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 DAWSON LANE
Mailing Address - Street 2:NONE
Mailing Address - City:BENTON
Mailing Address - State:KY
Mailing Address - Zip Code:42025-8448
Mailing Address - Country:US
Mailing Address - Phone:270-703-4937
Mailing Address - Fax:
Practice Address - Street 1:315 W 5TH ST STE 200
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:KY
Practice Address - Zip Code:42025-1152
Practice Address - Country:US
Practice Address - Phone:270-252-7200
Practice Address - Fax:270-252-7201
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0062652251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports