Provider Demographics
NPI:1164134391
Name:OLMSTED, KYLEIGH R (PT, DPT)
Entity Type:Individual
Prefix:MS
First Name:KYLEIGH
Middle Name:R
Last Name:OLMSTED
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 NE OAKS RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-1389
Mailing Address - Country:US
Mailing Address - Phone:316-295-9484
Mailing Address - Fax:
Practice Address - Street 1:1321 SW MARKET ST
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-2904
Practice Address - Country:US
Practice Address - Phone:816-607-7180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-07200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist