Healthcare Provider Details

I. General information

NPI: 1629982301
Provider Name (Legal Business Name): MANDY LEA ORF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15997 S CHESTER CT
OLATHE KS
66062-7049
US

IV. Provider business mailing address

15997 S CHESTER CT
OLATHE KS
66062-7049
US

V. Phone/Fax

Practice location:
  • Phone: 913-220-6538
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Q00000X
TaxonomyPathology Specialist/Technologist
License Number2003
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: