Provider Demographics
NPI:1588128565
Name:CALFAS, AMANDA PATRICE (ATC, LAT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:PATRICE
Last Name:CALFAS
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:PATRICE
Other - Last Name:GUESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:303 SW WHITE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-2426
Mailing Address - Country:US
Mailing Address - Phone:816-682-2557
Mailing Address - Fax:
Practice Address - Street 1:5815 NE 48TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64119-3899
Practice Address - Country:US
Practice Address - Phone:816-682-2557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO201500021452255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer