Healthcare Provider Details

I. General information

NPI: 1639875578
Provider Name (Legal Business Name): KAITLYN MANFRA PLOTSKY PT,DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2023
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

461 POND APPLE RD
CLARKSVILLE TN
37043-2208
US

IV. Provider business mailing address

690 W CREEK DR
CLARKSVILLE TN
37040-6742
US

V. Phone/Fax

Practice location:
  • Phone: 931-920-4333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1369670
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: