Provider Demographics
NPI:1831672146
Name:ENGLEHART, KAITLYN ELIZABETH (DPT)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:ELIZABETH
Last Name:ENGLEHART
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KAITLYN
Other - Middle Name:
Other - Last Name:LONGLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8040 WOLF RIVER BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1773
Mailing Address - Country:US
Mailing Address - Phone:901-522-6440
Mailing Address - Fax:901-757-2507
Practice Address - Street 1:8040 WOLF RIVER BLVD STE 102
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1773
Practice Address - Country:US
Practice Address - Phone:901-522-6440
Practice Address - Fax:901-757-2507
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12609225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist