MEDICARE: KILEY ETHRIDGE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT9469	AL
2	225100000X	Physical Therapist	PT44201	FL

General Provider Information

NPI Number	:	1922964345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KILEY ETHRIDGE

Provider Business Mailing Address
First Line	:	21 CAISSON TRCE
Second Line	:
City	:	SPANISH FORT
State	:	AL
Zip	:	36527-3101
Country	:	US
Telephone Number	:	334-726-4547
Fax Number	:

Provider Business Practice Location Address
First Line	:	7830 PINE FOREST RD
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32526-8404
Country	:	US
Telephone Number	:	850-941-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2025
Last Update Date	:	12/30/2025

Similar Medicare Providers

1861537268 — MRS. MARGARETA M ROES PT
Practice Location Address:

7830 PINE FOREST RD # COTTAGEA
PENSACOLA, FL
32526-8404

Practice Phone: 850-741-6715
Practice Fax: 850-204-0489

1497294409 — AMANDA GREEN SLP
Practice Location Address:

7830 PINE FOREST RD
PENSACOLA, FL
32526-8404

Practice Phone: 850-741-6715
Practice Fax: 850-204-0489

1548785249 — KIM DOUGLAS
Practice Location Address:

7830 PINE FOREST RD , COTTAGE A
PENSACOLA, FL
32526-8404

Practice Phone: 850-741-6715
Practice Fax: 850-204-0489

1205322195 — SILAS TUCKER DPT
Practice Location Address:

7830 PINE FOREST RD # COTTAGEA
PENSACOLA, FL
32526-8404

Practice Phone: 507-416-7158
Practice Fax: 850-204-0489

1972113926 — JENNIFER MESSER
Practice Location Address:

7830 PINE FOREST RD
PENSACOLA, FL
32526-8404

Practice Phone: 850-941-5000
Practice Fax:

1649859281 — NANCY GARCIE
Practice Location Address:

7830 PINE FOREST RD
PENSACOLA, FL
32526-8404

Practice Phone: 318-674-0323
Practice Fax:

Directions to “ KILEY ETHRIDGE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.