Provider Demographics
NPI:1063838191
Name:COLLEY, KRISTY (LMT)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:
Last Name:COLLEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9809 W 118TH ST
Mailing Address - Street 2:APT 2
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-3185
Mailing Address - Country:US
Mailing Address - Phone:816-793-0152
Mailing Address - Fax:
Practice Address - Street 1:11960 QUIVIRA RD
Practice Address - Street 2:STE 200
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-2222
Practice Address - Country:US
Practice Address - Phone:913-402-7444
Practice Address - Fax:913-402-7450
Is Sole Proprietor?:No
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No374J00000XNursing Service Related ProvidersDoula