Healthcare Provider Details

I. General information

NPI: 1083531461
Provider Name (Legal Business Name): KILEY COUNTS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1630 E BRADFORD PKWY STE E
SPRINGFIELD MO
65804-6781
US

IV. Provider business mailing address

1630 E BRADFORD PKWY STE E
SPRINGFIELD MO
65804-6781
US

V. Phone/Fax

Practice location:
  • Phone: 417-881-2900
  • Fax: 417-881-2918
Mailing address:
  • Phone: 417-881-2900
  • Fax: 417-881-2918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2026028254
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: