Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 505 | SC |
NPI | 1053574814 |
---|---|
Provider Name | Ms. Marsha C. Callahan |
First Address | Charleston, SC 29407-7848 |
Second Address | Charleston, SC 29407-7848 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2008 |
Last Update Date | 02/07/2008 |