Provider Demographics
NPI:1598472318
Name:CALLISON, PATRICIA GILLESPIE (DPT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:GILLESPIE
Last Name:CALLISON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 COBBLESTONE CT
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-1823
Mailing Address - Country:US
Mailing Address - Phone:828-450-7715
Mailing Address - Fax:
Practice Address - Street 1:4221 GARRETT RD STE 1-2
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-3467
Practice Address - Country:US
Practice Address - Phone:919-493-1204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP21527225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist