Kaylie Marie Blackledge
Individual provider Active NPI Physical Therapy Assistant · Red Oak, IA
NPI 1821765900 · NPPES record last updated Aug 25, 2021
Key facts
- NPI
- 1821765900
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 108976 (IA)
- Practice address
- 2301 Eastern Ave
Red Oak, IA 51566-1300 - Phone
- (712) 623-7213
- NPI assigned
- Aug 25, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 108976 | IA | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 108976 | IA | Yes |
Addresses
Primary practice location
2301 Eastern Ave
Red Oak, IA 51566-1300
Mailing address
15646 300TH St
Treynor, IA 51575-7601
Phone (402) 680-0007
Other providers in Red Oak, IA
- Arlington Place of Red Oak II, Inc.
- William G Artherholt
- Audiological Services Inc.
- Claudia M. Balta
- Lane Beisel
- Kimberly Lynn Bond
- Dara Brandt
- Christel Erika De Guzman Bullis
- William Butz
- CCC PC
All providers in Red Oak, IA · Physical Therapy Assistant in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2021. 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.