Provider Demographics
NPI:1659170124
Name:KISER, KERRY DOYLE (PT)
Entity type:Individual
Prefix:
First Name:KERRY
Middle Name:DOYLE
Last Name:KISER
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6845 KNIGHTDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-9800
Mailing Address - Country:US
Mailing Address - Phone:919-844-6611
Mailing Address - Fax:
Practice Address - Street 1:6845 KNIGHTDALE BLVD
Practice Address - Street 2:
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-9800
Practice Address - Country:US
Practice Address - Phone:919-844-6611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP23888225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist