Provider Demographics
NPI:1013793942
Name:PEERY, KAYLEE DAWN (MS, LAT, ATC)
Entity Type:Individual
Prefix:MISS
First Name:KAYLEE
Middle Name:DAWN
Last Name:PEERY
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 W HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:MO
Mailing Address - Zip Code:64772-1029
Mailing Address - Country:US
Mailing Address - Phone:816-522-3190
Mailing Address - Fax:
Practice Address - Street 1:811 W HICKORY ST
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:MO
Practice Address - Zip Code:64772-2000
Practice Address - Country:US
Practice Address - Phone:417-448-2020
Practice Address - Fax:417-448-1923
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20130258292255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer