Provider Demographics
NPI:1750925905
Name:MITCHELL, KADIE MICHELLE (PT, DPT)
Entity type:Individual
Prefix:
First Name:KADIE
Middle Name:MICHELLE
Last Name:MITCHELL
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KADIE
Other - Middle Name:
Other - Last Name:COKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:909 S PARK ST STE E
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-4456
Practice Address - Country:US
Practice Address - Phone:770-834-8702
Practice Address - Fax:770-830-8106
Is Sole Proprietor?:No
Enumeration Date:2019-10-31
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH9640225100000X
GAPT015193225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist