Provider Demographics
NPI:1548023765
Name:CALDER, JASON (PT)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:CALDER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12004 WALNUT DR
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:MO
Mailing Address - Zip Code:64060-9082
Mailing Address - Country:US
Mailing Address - Phone:816-209-5651
Mailing Address - Fax:
Practice Address - Street 1:5400 N OAK TRFY STE 101
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-4689
Practice Address - Country:US
Practice Address - Phone:816-691-1795
Practice Address - Fax:816-346-7049
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004035761225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist