Provider Demographics
NPI:1518296565
Name:FARLEY, KYLE L (ATC)
Entity Type:Individual
Prefix:MR
First Name:KYLE
Middle Name:L
Last Name:FARLEY
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13316 E 93RD ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64138-5000
Mailing Address - Country:US
Mailing Address - Phone:816-699-1397
Mailing Address - Fax:816-350-2878
Practice Address - Street 1:3215 MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-1946
Practice Address - Country:US
Practice Address - Phone:816-350-2881
Practice Address - Fax:816-350-2878
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-21
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001272255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer