Provider Demographics
NPI:1043043649
Name:MCCALLUM, CHRISTINE CARDOGNO (DPT)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:CARDOGNO
Last Name:MCCALLUM
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:ALICIA
Other - Last Name:CARDOGNO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:37 EUNICE AVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-3102
Mailing Address - Country:US
Mailing Address - Phone:508-579-2323
Mailing Address - Fax:
Practice Address - Street 1:44 BEARFOOT RD STE 150
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-1562
Practice Address - Country:US
Practice Address - Phone:888-810-6772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20608225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist