Provider Demographics
NPI:1548749393
Name:PERKINS, CASEY MILLER (OTR/L)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:MILLER
Last Name:PERKINS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:RENEE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:539 WESLEY CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:DRESDEN
Mailing Address - State:TN
Mailing Address - Zip Code:38225-2247
Mailing Address - Country:US
Mailing Address - Phone:731-616-2338
Mailing Address - Fax:
Practice Address - Street 1:104 OXFORD ST
Practice Address - Street 2:
Practice Address - City:MARTIN
Practice Address - State:TN
Practice Address - Zip Code:38237-2428
Practice Address - Country:US
Practice Address - Phone:731-587-3422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-13
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11753224Z00000X
TN6709225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty