Provider Demographics
NPI:1427543818
Name:FOSTER, AMANDA E (DPT)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:E
Last Name:FOSTER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3810 N MULBERRY DR UNIT 202
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-1692
Mailing Address - Country:US
Mailing Address - Phone:913-486-2604
Mailing Address - Fax:
Practice Address - Street 1:3810 N MULBERRY DRIVE 202
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116
Practice Address - Country:US
Practice Address - Phone:913-486-2604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1305216225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist