Provider Demographics
NPI:1518530484
Name:CALLAWAY, RACHAEL M (DC)
Entity Type:Individual
Prefix:DR
First Name:RACHAEL
Middle Name:M
Last Name:CALLAWAY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 37TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6594
Mailing Address - Country:US
Mailing Address - Phone:772-492-9677
Mailing Address - Fax:636-938-1011
Practice Address - Street 1:1880 37TH ST STE 1
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6594
Practice Address - Country:US
Practice Address - Phone:772-492-9677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14602111N00000X
MO2021010445111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor