MEDICARE: STEVIE JO CALLAWAY

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	225700000X	Massage Therapist	MT-50280	AZ

General Provider Information

NPI Number	:	1831040716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVIE JO CALLAWAY

Provider Business Mailing Address
First Line	:	5300 N STETSON DR
Second Line	:
City	:	PRESCOTT VALLEY
State	:	AZ
Zip	:	86314-9326
Country	:	US
Telephone Number	:	928-821-4804
Fax Number	:

Provider Business Practice Location Address
First Line	:	5300 N STETSON DR
Second Line	:
City	:	PRESCOTT VALLEY
State	:	AZ
Zip	:	86314-9326
Country	:	US
Telephone Number	:	928-821-4804
Fax Number	:

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

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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Directions to “ STEVIE JO CALLAWAY ” Practice Location

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