Provider Demographics
NPI:1821381955
Name:DEAN, KATHRYN FRANCES
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:FRANCES
Last Name:DEAN
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 1:1615 DEERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-5986
Mailing Address - Country:US
Mailing Address - Phone:931-217-8314
Mailing Address - Fax:
Practice Address - Street 1:211 DUNBAR CAVE RD
Practice Address - Street 2:SUITE A
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-8847
Practice Address - Country:US
Practice Address - Phone:931-648-2224
Practice Address - Fax:931-648-2225
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-23
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2467225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist