MEDICARE: DR. JUNE THOMAS CALLENDER 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
1	2251X0800X	Orthopedic Physical Therapist	9214	NC
2	225100000X	Physical Therapist	P9214	NC

General Provider Information

NPI Number	:	1972571859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUNE THOMAS CALLENDER DPT

Provider Business Mailing Address
First Line	:	720 REIGATE RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-2568
Country	:	US
Telephone Number	:	704-719-9690
Fax Number	:

Provider Business Practice Location Address
First Line	:	8401 MEDICAL PLAZA DR
Second Line	:	SUITE 230
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-8797
Country	:	US
Telephone Number	:	704-384-1536
Fax Number	:	704-384-1695

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

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	07/11/2013

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