Healthcare Provider Details

I. General information

NPI: 1942327960
Provider Name (Legal Business Name): KASEY LEIGH KASAK PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KASEY LEIGH KASEY PT

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 02/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2265 HARRODSBURG RD SUITE 350
LEXINGTON KY
40504-3500
US

IV. Provider business mailing address

PO BOX 911148
LEXINGTON KY
40591-1148
US

V. Phone/Fax

Practice location:
  • Phone: 859-278-2121
  • Fax: 859-276-1649
Mailing address:
  • Phone: 859-278-2121
  • Fax: 859-276-1649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number004574
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: