Provider Demographics
NPI:1376330548
Name:MCCALL, MARY ELIZABETH (PROSTHETIC/ORTHOTIC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:MCCALL
Suffix:
Gender:F
Credentials:PROSTHETIC/ORTHOTIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15712 W DESERT HILLS DR
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-1006
Mailing Address - Country:US
Mailing Address - Phone:623-302-8804
Mailing Address - Fax:
Practice Address - Street 1:13065 W GRAND AVE STE 6&7
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-7047
Practice Address - Country:US
Practice Address - Phone:623-302-8804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier