Provider Demographics
NPI:1518741677
Name:HAMMONDS, CALISTA ANNE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:CALISTA
Middle Name:ANNE
Last Name:HAMMONDS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4012 WHITE PINE LN
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40031-6972
Mailing Address - Country:US
Mailing Address - Phone:513-502-2279
Mailing Address - Fax:
Practice Address - Street 1:2525 BARDSTOWN RD STE 108
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2680
Practice Address - Country:US
Practice Address - Phone:502-537-6166
Practice Address - Fax:502-537-6167
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008902225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist