Healthcare Provider Details

I. General information

NPI: 1306766068
Provider Name (Legal Business Name): KAELI MCENTEER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 CARBONTON RD
SANFORD NC
27330-4009
US

IV. Provider business mailing address

106 OXYARD WAY
CARY NC
27519-7327
US

V. Phone/Fax

Practice location:
  • Phone: 919-777-0240
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: