Provider Demographics
NPI:1154459295
Name:MYERS, KAY J (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:KAY
Middle Name:J
Last Name:MYERS
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:MRS
Other - First Name:SUSAN
Other - Middle Name:KAY
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:419 GOLF CLUB RD
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110
Mailing Address - Country:US
Mailing Address - Phone:931-668-5008
Mailing Address - Fax:
Practice Address - Street 1:825 FISHER AVE
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37166
Practice Address - Country:US
Practice Address - Phone:615-597-4284
Practice Address - Fax:615-597-0734
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN1293225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist