Provider Demographics
NPI:1740766179
Name:MCLAIN, KASEY
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:
Last Name:MCLAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5925 N LENOX AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-2727
Mailing Address - Country:US
Mailing Address - Phone:704-214-6527
Mailing Address - Fax:
Practice Address - Street 1:2820 S 80TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-3266
Practice Address - Country:US
Practice Address - Phone:866-651-8791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-18
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist