MEDICARE: CHLOE CALLISON PA-C

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	363A00000X	Physician Assistant	50.006546RX	OH

General Provider Information

NPI Number	:	1326655853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHLOE CALLISON PA-C

Provider Business Mailing Address
First Line	:	3170 KETTERING BLVD # B2
Second Line	:
City	:	MORAINE
State	:	OH
Zip	:	45439-1924
Country	:	US
Telephone Number	:	937-208-4200
Fax Number	:	937-208-2678

Provider Business Practice Location Address
First Line	:	30 E APPLE ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45409-2939
Country	:	US
Telephone Number	:	937-208-4200
Fax Number	:

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

Provider Enumeration Date	:	09/29/2020
Last Update Date	:	04/20/2026

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Directions to “ CHLOE CALLISON PA-C” Practice Location

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