Healthcare Provider Details

I. General information

NPI: 1184505349
Provider Name (Legal Business Name): KILEY KIRKPATRICK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2025
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1839 E INDEPENDENCE ST UNIT R
SPRINGFIELD MO
65804-3753
US

IV. Provider business mailing address

3223 N WEBB RD STE 2
WICHITA KS
67226-8176
US

V. Phone/Fax

Practice location:
  • Phone: 316-260-3311
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2025038937
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: