Healthcare Provider Details

I. General information

NPI: 1306251152
Provider Name (Legal Business Name): KYLIE ANNE PALERMO DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2014
Last Update Date: 10/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7932 N OAK TRFY STE 212
KANSAS CITY MO
64118-1423
US

IV. Provider business mailing address

8823 PRODUCTION LN
OOLTEWAH TN
37363-6511
US

V. Phone/Fax

Practice location:
  • Phone: 816-420-0286
  • Fax: 816-420-8207
Mailing address:
  • Phone: 816-226-4011
  • Fax: 816-524-6115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-04843
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2014023633
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: