MEDICARE: PATRICIA CALLISON DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	P21527	NC

General Provider Information

NPI Number	:	1598472318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA CALLISON DPT

Provider Business Mailing Address
First Line	:	1010 CADENZA ST
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27707-5479
Country	:	US
Telephone Number	:	828-450-7715
Fax Number	:

Provider Business Practice Location Address
First Line	:	4221 GARRETT RD STE 1-2
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27707-3467
Country	:	US
Telephone Number	:	919-493-1204
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2022
Last Update Date	:	06/15/2026

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