Provider Demographics
NPI:1437026267
Name:PERRY, KAILEE MACKENZIE
Entity type:Individual
Prefix:
First Name:KAILEE
Middle Name:MACKENZIE
Last Name:PERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 IKE FERGUSON RD
Mailing Address - Street 2:
Mailing Address - City:WEST LIBERTY
Mailing Address - State:KY
Mailing Address - Zip Code:41472-7455
Mailing Address - Country:US
Mailing Address - Phone:614-981-2065
Mailing Address - Fax:
Practice Address - Street 1:1270 E POWELL RD
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-8619
Practice Address - Country:US
Practice Address - Phone:614-981-2065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-17
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY009391225100000X
OHCP049947T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist