Provider Demographics
NPI:1770013039
Name:MOYERS HORNICK, KELSEY ALEXIS (DPT)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:ALEXIS
Last Name:MOYERS HORNICK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7811 OAK RIDGE HWY STE 3
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37931-2345
Mailing Address - Country:US
Mailing Address - Phone:865-230-3243
Mailing Address - Fax:423-419-5506
Practice Address - Street 1:7811 OAK RIDGE HWY STE 3
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37931-2345
Practice Address - Country:US
Practice Address - Phone:865-313-2455
Practice Address - Fax:865-313-2455
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000011267225100000X
TN11267225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist