Provider Demographics
NPI:1679522726
Name:CALLE, JOHN (PT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:CALLE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:JUAN
Other - Middle Name:
Other - Last Name:CALLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:121 FRIENDS LA
Mailing Address - Street 2:SUITE 700
Mailing Address - City:NEW TOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940
Mailing Address - Country:US
Mailing Address - Phone:215-497-9758
Mailing Address - Fax:215-497-9759
Practice Address - Street 1:121 FRIENDS LA
Practice Address - Street 2:SUITE 700
Practice Address - City:NEW TOWM
Practice Address - State:PA
Practice Address - Zip Code:18940
Practice Address - Country:US
Practice Address - Phone:215-497-9758
Practice Address - Fax:215-497-9759
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT006628L2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA044103QXDMedicare ID - Type Unspecified