Provider Demographics
NPI:1407143050
Name:CALLAHAN, MAI-VI (PT, DPT, OCS)
Entity Type:Individual
Prefix:
First Name:MAI-VI
Middle Name:
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1428 KINGSLEY RD
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33469-2916
Mailing Address - Country:US
Mailing Address - Phone:352-284-9765
Mailing Address - Fax:
Practice Address - Street 1:222 S US HIGHWAY 1 STE 208D
Practice Address - Street 2:
Practice Address - City:TEQUESTA
Practice Address - State:FL
Practice Address - Zip Code:33469-2708
Practice Address - Country:US
Practice Address - Phone:561-277-6607
Practice Address - Fax:561-277-6607
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL265802251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic