Individual
MR. DARRYL L OLIVE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
517 CAMPBELL ST, KANSAS CITY, MO 64106-1213
(816) 699-2928
(816) 466-5969
Mailing address
517 CAMPBELL ST, KANSAS CITY, MO 64106-1213
(816) 699-2928
(816) 466-5969
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
09980-01073
KS
226300000X
Kinesiotherapist
YA-34381
KS
363A00000X
Physician Assistant
Primary
1502108
KS
363A00000X
Physician Assistant
Primary
2019013315
MO
Other
Enumeration date
03/29/2010
Last updated
02/20/2026
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