Provider Demographics
NPI:1053574814
Name:CALLAHAN, MARSHA C (PT)
Entity type:Individual
Prefix:MS
First Name:MARSHA
Middle Name:C
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 SAVANNAH HWY STE D
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-7848
Mailing Address - Country:US
Mailing Address - Phone:843-769-7773
Mailing Address - Fax:843-329-4043
Practice Address - Street 1:1319 SAVANNAH HWY STE D
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7848
Practice Address - Country:US
Practice Address - Phone:843-769-7773
Practice Address - Fax:843-329-4043
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5052251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics