Provider Demographics
NPI:1699364356
Name:CANTRELL, KAYLEA DAWN (DC)
Entity Type:Individual
Prefix:DR
First Name:KAYLEA
Middle Name:DAWN
Last Name:CANTRELL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 N SUMAC ST
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:KS
Mailing Address - Zip Code:66030-2211
Mailing Address - Country:US
Mailing Address - Phone:918-740-6661
Mailing Address - Fax:
Practice Address - Street 1:6540 W 95TH ST STE 102
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-1491
Practice Address - Country:US
Practice Address - Phone:913-286-4968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-15
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-06103111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor