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NPI Code Detail

MEDICARE: JUSTINE S CALLAGHAN DPT

MEDICARE: JUSTINE S CALLAGHAN 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
1225100000XPhysical Therapist17234MA

General Provider Information

NPI Number : 1023219854
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTINE S CALLAGHAN DPT
Provider Business Mailing Address
First Line : 66 COTTAGE ST
Second Line :
City : MANSFIELD
State : MA
Zip : 02048
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 23 ISAAC ST
Second Line :
City : MIDDLEBORO
State : MA
Zip : 02346-2080
Country : US
Telephone Number : 508-947-9295
Fax Number : 508-947-7974
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2007
Last Update Date : 12/16/2011

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Directions to “ JUSTINE S CALLAGHAN DPT” Practice Location

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