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General NPI Number Information
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NPI Number | 1144375379
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Entity Type | Individual
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Provider Name | KELLY CALHOUN MHS, PT
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Gender | Female
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3630 BUSINESS DR
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City | SACRAMENTO
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State | CA
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Zip | 95820-2163
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Country | US
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Telephone | 916-734-2458
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Fax |
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Provider Business Mailing Address
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Address Line | 3045 AUDUBON CIR
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City | DAVIS
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State | CA
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Zip | 95616-7605
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Country | US
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Telephone | 530-848-0606
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Fax | 530-757-6660
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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 | PT 29392
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License Number State | CA
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