Provider Demographics
NPI:1598895047
Name:FARLEY, KRISTI LEIGH (PT DPT)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:LEIGH
Last Name:FARLEY
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:L
Other - Last Name:SAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 543
Mailing Address - Street 2:
Mailing Address - City:GRAYS KNOB
Mailing Address - State:KY
Mailing Address - Zip Code:40829
Mailing Address - Country:US
Mailing Address - Phone:606-526-2919
Mailing Address - Fax:
Practice Address - Street 1:383 CORBIN CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701
Practice Address - Country:US
Practice Address - Phone:606-529-2919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004865225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY5024718Medicare ID - Type Unspecified