Provider Demographics
NPI:1336429067
Name:KERN, DANELLE S (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MISS
First Name:DANELLE
Middle Name:S
Last Name:KERN
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 GRANNY SCOTT RD
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:38485-5706
Mailing Address - Country:US
Mailing Address - Phone:931-300-3069
Mailing Address - Fax:
Practice Address - Street 1:510 GRANNY SCOTT RD
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:TN
Practice Address - Zip Code:38485-5706
Practice Address - Country:US
Practice Address - Phone:931-300-3069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT25067225100000X
TNPT9827225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist