Provider Demographics
NPI:1861679474
Name:CALLOW, JOSH
Entity Type:Individual
Prefix:
First Name:JOSH
Middle Name:
Last Name:CALLOW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21791 HIGHWAY 9
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50436-7318
Mailing Address - Country:US
Mailing Address - Phone:641-581-3595
Mailing Address - Fax:641-581-3595
Practice Address - Street 1:21791 HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:IA
Practice Address - Zip Code:50436-7318
Practice Address - Country:US
Practice Address - Phone:641-581-3595
Practice Address - Fax:641-581-3595
Is Sole Proprietor?:No
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA842ZZ1775171W00000X, 171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No171WH0202XOther Service ProvidersContractorHome Modifications