Provider Demographics
NPI:1891308581
Name:PEAY, KAYLA
Entity Type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:
Last Name:PEAY
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:PEAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:7926 BRONZE PIKE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-5692
Mailing Address - Country:US
Mailing Address - Phone:336-451-2090
Mailing Address - Fax:
Practice Address - Street 1:19530 MT ZION PKWY
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-8398
Practice Address - Country:US
Practice Address - Phone:704-997-2970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist