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NPI Code Detail

MEDICARE: CIERRA N CALLOWAY OTR/L

MEDICARE: CIERRA N CALLOWAY OTR/L
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
1225X00000XOccupational Therapist0119008471VA

General Provider Information

NPI Number : 1902438625
Entity Type Code : Individual
Provider Name (Legal Business Name) : CIERRA N CALLOWAY OTR/L
Provider Business Mailing Address
First Line : 1575 SCOTT DR
Second Line :
City : FARMVILLE
State : VA
Zip : 23901-2662
Country : US
Telephone Number : 434-392-8806
Fax Number :
Provider Business Practice Location Address
First Line : 1040 GABLES DR
Second Line :
City : FOREST
State : VA
Zip : 24551-4996
Country : US
Telephone Number : 804-508-6499
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2020
Last Update Date : 11/18/2025

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Directions to “ CIERRA N CALLOWAY OTR/L” Practice Location

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