Provider Demographics
NPI:1629183835
Name:COLBY CALHOUN, KRISANNE KAY (PT)
Entity Type:Individual
Prefix:
First Name:KRISANNE
Middle Name:KAY
Last Name:COLBY CALHOUN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:KRISANNE
Other - Middle Name:KAY
Other - Last Name:COLBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:205 W WACKER DR
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-1216
Mailing Address - Country:US
Mailing Address - Phone:312-640-0329
Mailing Address - Fax:
Practice Address - Street 1:7011 DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-3223
Practice Address - Country:US
Practice Address - Phone:515-251-3700
Practice Address - Fax:515-251-3733
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02273225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist