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General NPI Number Information
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NPI Number | 1982477972
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Entity Type | Individual
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Provider Name | KYLEE NICHOLE PERKINS PTA
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Gender | Female
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Dates
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Enumeration Date | 11/01/2023
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 606 W LOVERS LN
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City | MEMPHIS
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State | MO
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Zip | 63555-1931
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Country | US
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Telephone | 660-465-8532
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Fax |
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Provider Business Mailing Address
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Address Line | 23998 COUNTY ROAD 758
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City | MEMPHIS
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State | MO
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Zip | 63555-8602
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Country | US
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Telephone | 660-342-6000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2023028477
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License Number State | MO
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