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NPI Code Detail

MEDICARE: MATTHEW CALLAHAN PT, DPT

MEDICARE:   MATTHEW  CALLAHAN  PT, DPT
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
1225100000XPhysical Therapist5501017984MI

General Provider Information

NPI Number : 1952843773
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW CALLAHAN PT, DPT
Provider Business Mailing Address
First Line : 2469 E FARRAND RD
Second Line :
City : CLIO
State : MI
Zip : 48420-9173
Country : US
Telephone Number : 810-686-6797
Fax Number :
Provider Business Practice Location Address
First Line : 1429 FLUSHING RD STE A
Second Line :
City : FLUSHING
State : MI
Zip : 48433-2228
Country : US
Telephone Number : 810-487-9128
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2016
Last Update Date : 03/29/2018

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Directions to “ MATTHEW CALLAHAN PT, DPT” Practice Location

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