Healthcare Provider Details

I. General information

NPI: 1053169318
Provider Name (Legal Business Name): KAITLYN OAKS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAITLYN MIER DPT

II. Dates (important events)

Enumeration Date: 05/10/2024
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1208 CULLMAN SHOPPING CTR NW
CULLMAN AL
35055-2856
US

IV. Provider business mailing address

2823 GREYSTONE COMMERCIAL BLVD
HOOVER AL
35242-2660
US

V. Phone/Fax

Practice location:
  • Phone: 256-775-4456
  • Fax:
Mailing address:
  • Phone: 205-745-3660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH11820
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: