Kelly Haag
Individual provider Active NPI Physical Therapy Assistant · Tullahoma, TN
NPI 1205946191 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1205946191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- Practice address
- 1802 N Jackson St
Suite 820
Tullahoma, TN 37388-8218 - Phone
- (931) 455-5335
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Select Physical Therapy Holdings, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | Yes |
Addresses
Primary practice location
1802 N Jackson St
Suite 820
Tullahoma, TN 37388-8218
Mailing address
599 Old Seminary Rd
Manchester, TN 37355-7705
Phone (931) 728-8601
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2279 | Other | TN | LICENSE # |
Other providers in Tullahoma, TN
- Annie Grimes
- Danielle Knight Gruber
- Gulla Bala Krishna MD PC
- Rimda Gupta
- Kahly Marie Gurule
- Natascha Haggard
- Paul M Haidak
- Jennifer Hall
- William Dyrk Halstead
- Jessica Smith Hamm
All providers in Tullahoma, TN · Physical Therapy Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.