Provider Demographics
NPI:1538893706
Name:SIVLEY, KELLY ELIZABETH (PT, DPT)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:ELIZABETH
Last Name:SIVLEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 SUNNYMEADE DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37216-2527
Mailing Address - Country:US
Mailing Address - Phone:602-370-7092
Mailing Address - Fax:
Practice Address - Street 1:7135 CHARLOTTE PIKE STE 102
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-5017
Practice Address - Country:US
Practice Address - Phone:615-540-8334
Practice Address - Fax:615-469-4321
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-13
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14438225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty