Provider Demographics
NPI:1942934500
Name:KENT, CASEY ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:CASEY
Middle Name:ANN
Last Name:KENT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 COUNTY ROAD 755
Mailing Address - Street 2:
Mailing Address - City:RICEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37370-5252
Mailing Address - Country:US
Mailing Address - Phone:678-381-6628
Mailing Address - Fax:
Practice Address - Street 1:698 PAUL HUFF PKWY NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-2958
Practice Address - Country:US
Practice Address - Phone:423-455-5289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-11
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3610111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor