Provider Demographics
NPI:1346088960
Name:CONLAN, KAYLEE WILSON (DC)
Entity type:Individual
Prefix:DR
First Name:KAYLEE
Middle Name:WILSON
Last Name:CONLAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 SEATTLE SLEW ST
Mailing Address - Street 2:
Mailing Address - City:HEWITT
Mailing Address - State:TX
Mailing Address - Zip Code:76643-4112
Mailing Address - Country:US
Mailing Address - Phone:806-773-5112
Mailing Address - Fax:
Practice Address - Street 1:1075 SEATTLE SLEW ST
Practice Address - Street 2:
Practice Address - City:HEWITT
Practice Address - State:TX
Practice Address - Zip Code:76643-4112
Practice Address - Country:US
Practice Address - Phone:806-773-5112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16102111NP0017X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor