MEDICARE: RACHEL CALLISTER

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	2255A2300X	Athletic Trainer	14232216-4810	UT

General Provider Information

NPI Number	:	1164201083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL CALLISTER

Provider Business Mailing Address
First Line	:	907 E 600 N
Second Line	:
City	:	OREM
State	:	UT
Zip	:	84097-4219
Country	:	US
Telephone Number	:	801-922-0943
Fax Number	:

Provider Business Practice Location Address
First Line	:	1157 N 300 W STE 301
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-6124
Country	:	US
Telephone Number	:	801-357-1200
Fax Number	:	801-357-1239

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

Provider Enumeration Date	:	09/28/2023
Last Update Date	:	02/06/2026

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Directions to “ RACHEL CALLISTER ” Practice Location

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