Healthcare Provider Details

I. General information

NPI: 1619806957
Provider Name (Legal Business Name): KYLIE ANN OVERBAY DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15434 W 128TH ST
OLATHE KS
66062-5998
US

IV. Provider business mailing address

15434 W 128TH ST
OLATHE KS
66062-5998
US

V. Phone/Fax

Practice location:
  • Phone: 605-350-6609
  • Fax:
Mailing address:
  • Phone: 605-350-6609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number01-06479
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: