Callow, Stacy Ranae

Callow, Stacy Ranae is an individual health care provider with primary practice located at 63 Hospitality Ln Suite 1, Mineral Wells WV 26150-6704. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Callow, Stacy Ranae can be contacted via phone (304) 489-8100.

Contact Information

Primary practice address
63 Hospitality Ln Suite 1 Mineral Wells WV 26150-6704
Phone: (304) 489-8100
Fax: (304) 489-8191
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 002524 West Virginia

Profile Details

NPI number 1023129129
LBN Legal business name Callow, Stacy Ranae
Credentials DPT, OCS
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Apr 4th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023129129 NPPES
West Virginia MEDICAID 3810007455
West Virginia MEDICAID 2702623
West Virginia Other P00352738

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