MEDICARE: DR. MICHAELENE CALLAHAN D.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	111N00000X	Chiropractor	6091	NJ
2	111N00000X	Chiropractor	9087	NY
3	111N00000X	Chiropractor	CH12983	FL

General Provider Information

NPI Number	:	1366564254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAELENE CALLAHAN D.C.

Provider Business Mailing Address
First Line	:	141 BUCKSKIN LN
Second Line	:
City	:	ORMOND BEACH
State	:	FL
Zip	:	32174-8005
Country	:	US
Telephone Number	:	407-502-8777
Fax Number	:

Provider Business Practice Location Address
First Line	:	141 BUCKSKIN LN
Second Line	:
City	:	ORMOND BEACH
State	:	FL
Zip	:	32174-8005
Country	:	US
Telephone Number	:	407-502-8777
Fax Number	:

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

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	04/13/2024

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