Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ||
N | 222Z00000X | Podiatrist | ||
Y | 224P00000X | Prosthetist |
NPI | 1316422389 |
---|---|
Provider Name | Mrs. Casey R Calvert |
First Address | Madison, WI 53719-1124 |
Second Address | Madison, WI 53719-1124 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2018 |
Last Update Date | 26/09/2018 |