Provider Demographics
NPI:1467864710
Name:BALL, KAITLIN ANNE (DPT)
Entity type:Individual
Prefix:MRS
First Name:KAITLIN
Middle Name:ANNE
Last Name:BALL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KAITLIN
Other - Middle Name:
Other - Last Name:VANRADEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:4472 ELLIS CIR NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-3326
Mailing Address - Country:US
Mailing Address - Phone:423-380-6263
Mailing Address - Fax:423-380-6264
Practice Address - Street 1:4472 ELLIS CIR NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-3326
Practice Address - Country:US
Practice Address - Phone:423-380-6263
Practice Address - Fax:423-380-6264
Is Sole Proprietor?:No
Enumeration Date:2014-05-21
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000009856225100000X
TN98562251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic