Provider Demographics
NPI:1932540408
Name:WINGO, KATEY CHRISTINE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KATEY
Middle Name:CHRISTINE
Last Name:WINGO
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 1:8110 CORDOVA RD STE 107
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-0521
Mailing Address - Country:US
Mailing Address - Phone:901-756-1650
Mailing Address - Fax:901-756-1396
Practice Address - Street 1:8110 CORDOVA RD STE 107
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-0521
Practice Address - Country:US
Practice Address - Phone:901-756-1650
Practice Address - Fax:901-756-1396
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9541225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist