Provider Demographics
NPI:1922378959
Name:FARLEE, KYLE ALLEN (CPTA)
Entity Type:Individual
Prefix:MR
First Name:KYLE
Middle Name:ALLEN
Last Name:FARLEE
Suffix:
Gender:M
Credentials:CPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 E NETTLETON AVE
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64050-2941
Mailing Address - Country:US
Mailing Address - Phone:816-394-9655
Mailing Address - Fax:
Practice Address - Street 1:201 E FLAMING RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-5343
Practice Address - Country:US
Practice Address - Phone:916-829-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-00832225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant