Provider Demographics
NPI:1861578221
Name:DRIVER, KELLY LYNN (LPTA)
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:LYNN
Last Name:DRIVER
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 89
Mailing Address - Street 2:8258 NASHVILLE HWY
Mailing Address - City:DOWELLTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37059
Mailing Address - Country:US
Mailing Address - Phone:615-536-5337
Mailing Address - Fax:
Practice Address - Street 1:1014 SOUTH CHANCERY ST
Practice Address - Street 2:NHC REHABILITATION
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110
Practice Address - Country:US
Practice Address - Phone:931-506-9234
Practice Address - Fax:931-506-9235
Is Sole Proprietor?:No
Enumeration Date:2006-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2719225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant