Provider Demographics
NPI:1467250852
Name:PALO, JEFFERSON (PT, DPT)
Entity type:Individual
Prefix:
First Name:JEFFERSON
Middle Name:
Last Name:PALO
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JEFF
Other - Middle Name:
Other - Last Name:PALO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:3119 NE 59TH TER APT 2
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:MO
Mailing Address - Zip Code:64119-2138
Mailing Address - Country:US
Mailing Address - Phone:816-785-4467
Mailing Address - Fax:
Practice Address - Street 1:2800 CLAY EDWARDS DR
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3220
Practice Address - Country:US
Practice Address - Phone:816-691-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025005925225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist