Provider Demographics
NPI:1376168294
Name:PALMER, BAYLI ANN (DPT)
Entity Type:Individual
Prefix:
First Name:BAYLI
Middle Name:ANN
Last Name:PALMER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 N DAVIN LN
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-3608
Mailing Address - Country:US
Mailing Address - Phone:316-640-5064
Mailing Address - Fax:
Practice Address - Street 1:10333 E 21ST ST N STE 406
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-3547
Practice Address - Country:US
Practice Address - Phone:316-630-9944
Practice Address - Fax:316-630-9945
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-06432225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist