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General NPI Number Information
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NPI Number | 1184515975
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Entity Type | Individual
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Provider Name | MARIA ELIZABETH CALLAHAN PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 07/10/2025
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 17305 CEDAR AVE S STE 110
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City | LAKEVILLE
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State | MN
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Zip | 55044-3902
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Country | US
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Telephone | 952-953-3711
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Fax |
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Provider Business Mailing Address
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Address Line | 175 W KRAFT RD
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City | WEST ST PAUL
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State | MN
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Zip | 55118-3800
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Country | US
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Telephone | 651-373-0251
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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 | 14004
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License Number State | MN
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