Provider Demographics
NPI:1821272915
Name:CORNETT, KATHLEEN SAVAGE (PT)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:SAVAGE
Last Name:CORNETT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1241 VOLUNTEER PKWY
Mailing Address - Street 2:SUITE 440
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-4659
Mailing Address - Country:US
Mailing Address - Phone:423-789-2010
Mailing Address - Fax:888-734-2212
Practice Address - Street 1:1241 VOLUNTEER PKWY
Practice Address - Street 2:SUITE 440
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-4659
Practice Address - Country:US
Practice Address - Phone:423-789-2010
Practice Address - Fax:888-734-2212
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1963225100000X
VA2305002275225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist