Provider Demographics
NPI:1801363684
Name:AGEE, CASEY NICOLE (DPT)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:NICOLE
Last Name:AGEE
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 1:1730 UPPER HELTON RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:TN
Mailing Address - Zip Code:37012-3531
Mailing Address - Country:US
Mailing Address - Phone:615-529-3389
Mailing Address - Fax:
Practice Address - Street 1:527 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37166-1137
Practice Address - Country:US
Practice Address - Phone:615-215-5470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7342225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist