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General NPI Number Information
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NPI Number | 1043043649
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Entity Type | Individual
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Provider Name | CHRISTINE CARDOGNO MCCALLUM DPT
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Gender | Female
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Dates
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Enumeration Date | 08/21/2024
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 44 BEARFOOT RD STE 150
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City | NORTHBOROUGH
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State | MA
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Zip | 01532-1562
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Country | US
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Telephone | 888-810-6772
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Fax |
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Provider Business Mailing Address
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Address Line | 37 EUNICE AVE
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City | WORCESTER
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State | MA
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Zip | 01606-3102
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Country | US
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Telephone | 508-579-2323
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 20608
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License Number State | MA
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