Individual
DR. DEIDRE M CALLANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
13065 E 17TH AVE, AURORA, CO 80045-2532
(303) 724-8290
Mailing address
155 UNION ST, SPRINGFIELD, MA 01105-2010
(413) 732-0088
(413) 737-9879
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2121
MA
124Q00000X
Dental Hygienist
Primary
000906283
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2121
LICENSE
MA
01
—
YY3061
BCBS INDIVIDUAL #
MA
Enumeration date
05/25/2006
Last updated
07/21/2022
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