Provider Demographics
NPI:1447099833
Name:MEFFORD, CALLIE JEAN (DPT)
Entity type:Individual
Prefix:
First Name:CALLIE
Middle Name:JEAN
Last Name:MEFFORD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CALLIE
Other - Middle Name:JEAN
Other - Last Name:WARREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 N EAGLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1806
Mailing Address - Country:US
Mailing Address - Phone:615-934-1023
Mailing Address - Fax:
Practice Address - Street 1:101 N EAGLE CREEK DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1806
Practice Address - Country:US
Practice Address - Phone:859-294-8320
Practice Address - Fax:859-299-3508
Is Sole Proprietor?:No
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY009063225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist