Provider Demographics
NPI:1316425234
Name:REVETTE, KAITLYN GRIFFITH (DPT)
Entity type:Individual
Prefix:MRS
First Name:KAITLYN
Middle Name:GRIFFITH
Last Name:REVETTE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 CHESNUT BYP
Mailing Address - Street 2:
Mailing Address - City:CENTRE
Mailing Address - State:AL
Mailing Address - Zip Code:35960-2816
Mailing Address - Country:US
Mailing Address - Phone:256-927-2456
Mailing Address - Fax:256-927-2460
Practice Address - Street 1:1504 CHESNUT BYP
Practice Address - Street 2:
Practice Address - City:CENTRE
Practice Address - State:AL
Practice Address - Zip Code:35960-2816
Practice Address - Country:US
Practice Address - Phone:256-927-2456
Practice Address - Fax:256-927-2460
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2025-12-05
Deactivation Date:2025-08-15
Deactivation Code:
Reactivation Date:2025-11-17
Provider Licenses
StateLicense IDTaxonomies
ALPTH9001225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist