Provider Demographics
NPI:1942327960
Name:KASAK, KASEY LEIGH (PT)
Entity Type:Individual
Prefix:MS
First Name:KASEY
Middle Name:LEIGH
Last Name:KASAK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:KASEY
Other - Middle Name:LEIGH
Other - Last Name:KASEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 911148
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40591-1148
Mailing Address - Country:US
Mailing Address - Phone:859-278-2121
Mailing Address - Fax:859-276-1649
Practice Address - Street 1:2265 HARRODSBURG RD
Practice Address - Street 2:SUITE 350
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3500
Practice Address - Country:US
Practice Address - Phone:859-278-2121
Practice Address - Fax:859-276-1649
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004574225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist