Provider Demographics
NPI:1306168950
Name:JENSEN, KYLE COLBY (DC)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:COLBY
Last Name:JENSEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 W 43RD ST STE A
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3133
Mailing Address - Country:US
Mailing Address - Phone:816-831-1300
Mailing Address - Fax:816-831-1301
Practice Address - Street 1:917 W 43RD ST STE A
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3133
Practice Address - Country:US
Practice Address - Phone:816-831-1300
Practice Address - Fax:816-831-1301
Is Sole Proprietor?:No
Enumeration Date:2010-02-24
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0105313111N00000X
MO2021000161111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor