Provider Demographics
NPI:1669766960
Name:EFFLAND, CALLIE M (PT)
Entity type:Individual
Prefix:
First Name:CALLIE
Middle Name:M
Last Name:EFFLAND
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CALLIE
Other - Middle Name:M
Other - Last Name:BRUEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1600 CHARLES PL
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2750
Mailing Address - Country:US
Mailing Address - Phone:785-537-4200
Mailing Address - Fax:785-537-4354
Practice Address - Street 1:1600 CHARLES PL
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2750
Practice Address - Country:US
Practice Address - Phone:785-537-4200
Practice Address - Fax:785-537-4354
Is Sole Proprietor?:No
Enumeration Date:2011-06-03
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1104297225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist