Provider Demographics
NPI:1659308070
Name:PAGEL, CALEEN MARIE (PT)
Entity Type:Individual
Prefix:MS
First Name:CALEEN
Middle Name:MARIE
Last Name:PAGEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:CALEEN
Other - Middle Name:MARIE
Other - Last Name:KROHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2130 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-4609
Mailing Address - Country:US
Mailing Address - Phone:563-263-1566
Mailing Address - Fax:
Practice Address - Street 1:2109 CEDARWOOD DR
Practice Address - Street 2:SUITE 100
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-2661
Practice Address - Country:US
Practice Address - Phone:563-288-6787
Practice Address - Fax:563-288-6719
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00942225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA49795OtherWELLMARK BC/BS
IA0263749Medicaid
IA650023544OtherMEDICARE RAILROAD
IAI6502Medicare ID - Type Unspecified