MEDICARE: CALLIE AVERY

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1396494977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CALLIE AVERY

Provider Business Mailing Address
First Line	:	317 HIGHLAND AVE
Second Line	:
City	:	CAMBRIDGE
State	:	OH
Zip	:	43725-2529
Country	:	US
Telephone Number	:	740-435-9766
Fax Number	:	740-432-4966

Provider Business Practice Location Address
First Line	:	1361 W MAIN ST
Second Line	:
City	:	ZANESVILLE
State	:	OH
Zip	:	43701-3123
Country	:	US
Telephone Number	:	740-450-7790
Fax Number	:	740-450-7754

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

Provider Enumeration Date	:	03/22/2022
Last Update Date	:	03/22/2022

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Directions to “ CALLIE AVERY ” Practice Location

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