Provider Demographics
NPI:1871389197
Name:WARD, KAYLA (PTA)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:WARD
Suffix:
Gender:
Credentials:PTA
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:SUZANNE
Other - Last Name:VAUGHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2598 S WESLEY CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-0325
Mailing Address - Country:US
Mailing Address - Phone:423-571-1465
Mailing Address - Fax:423-571-1465
Practice Address - Street 1:147 VERA RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-3756
Practice Address - Country:US
Practice Address - Phone:803-629-1981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306605402225200000X
TN6491225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant