Provider Demographics
NPI:1336749712
Name:JUND, CALLI (OTR)
Entity Type:Individual
Prefix:
First Name:CALLI
Middle Name:
Last Name:JUND
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:CALLI
Other - Middle Name:
Other - Last Name:OBERHOLTZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:6135 BROOKES WAY
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-1579
Mailing Address - Country:US
Mailing Address - Phone:701-400-2115
Mailing Address - Fax:
Practice Address - Street 1:315 S SETH CHILD RD
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-3003
Practice Address - Country:US
Practice Address - Phone:785-587-4235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-02865225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist