Provider Demographics
NPI:1861628067
Name:KENNEDY, KAYLA DEANN (DPT)
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:DEANN
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
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Mailing Address - Street 1:200 W DOUGLAS AVE
Mailing Address - Street 2:STE 1040
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-3013
Mailing Address - Country:US
Mailing Address - Phone:316-263-0003
Mailing Address - Fax:316-263-1241
Practice Address - Street 1:3730 N RIDGE RD
Practice Address - Street 2:STE 500
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1227
Practice Address - Country:US
Practice Address - Phone:316-440-4901
Practice Address - Fax:316-440-4904
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2011-06-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS11-04009225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist