Provider Demographics
NPI:1811667108
Name:FLEENOR, KASEY ELIZABETH (PT, DPT)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:ELIZABETH
Last Name:FLEENOR
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 HOWARD DR
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-8138
Mailing Address - Country:US
Mailing Address - Phone:615-614-8833
Mailing Address - Fax:
Practice Address - Street 1:301 S GALLAHER VIEW RD STE 1A
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5355
Practice Address - Country:US
Practice Address - Phone:615-614-8833
Practice Address - Fax:615-614-8811
Is Sole Proprietor?:No
Enumeration Date:2021-09-17
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13899225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist