Provider Demographics
NPI:1942285028
Name:CALLANEN, ANDREA S (PT, MPT)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:S
Last Name:CALLANEN
Suffix:
Gender:F
Credentials:PT, MPT
Other - Prefix:MISS
Other - First Name:ANDREA
Other - Middle Name:MARIE
Other - Last Name:SOBAJIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, MPT
Mailing Address - Street 1:316 MATHERSON CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-2670
Mailing Address - Country:US
Mailing Address - Phone:615-784-8104
Mailing Address - Fax:
Practice Address - Street 1:725 COOL SPRINGS BLVD STE 110
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-2712
Practice Address - Country:US
Practice Address - Phone:615-784-8104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-12
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 25646225100000X
TNPT0000098002251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT25646BMedicare PIN