Provider Demographics
NPI:1669367579
Name:SMEDLEY, KAELEIGH ROSE
Entity type:Individual
Prefix:
First Name:KAELEIGH
Middle Name:ROSE
Last Name:SMEDLEY
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 W RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17022-9308
Mailing Address - Country:US
Mailing Address - Phone:717-618-2535
Mailing Address - Fax:
Practice Address - Street 1:1245 CHURCH RD
Practice Address - Street 2:
Practice Address - City:WYNCOTE
Practice Address - State:PA
Practice Address - Zip Code:19095-1800
Practice Address - Country:US
Practice Address - Phone:215-884-9990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE013366208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation