Provider Demographics
NPI:1861830192
Name:ANFONE, EASTRE RINGON (PT, CLT)
Entity Type:Individual
Prefix:MISS
First Name:EASTRE
Middle Name:RINGON
Last Name:ANFONE
Suffix:
Gender:F
Credentials:PT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5252 S HONEYSUCKLE LN
Mailing Address - Street 2:
Mailing Address - City:BATTLEFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65619-8292
Mailing Address - Country:US
Mailing Address - Phone:417-895-8056
Mailing Address - Fax:417-720-1861
Practice Address - Street 1:5252 S HONEYSUCKLE LN
Practice Address - Street 2:
Practice Address - City:BATTLEFIELD
Practice Address - State:MO
Practice Address - Zip Code:65619-8292
Practice Address - Country:US
Practice Address - Phone:417-895-8056
Practice Address - Fax:417-720-1861
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-09
Last Update Date:2013-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO 102971225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist