Healthcare Provider Details

I. General information

NPI: 1093010704
Provider Name (Legal Business Name): HOLLY R LANE D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HOLLY OSMUNDSON DC

II. Dates (important events)

Enumeration Date: 01/11/2011
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22120 MIDLAND DR STE 1
SHAWNEE KS
66226-3554
US

IV. Provider business mailing address

22120 MIDLAND DR STE 1
SHAWNEE KS
66226-3554
US

V. Phone/Fax

Practice location:
  • Phone: 816-404-9120
  • Fax: 816-404-9122
Mailing address:
  • Phone: 913-745-4064
  • Fax: 913-745-4352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2011000682
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: