Individual
MRS. CALLIE MARIE MIZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.R.
Contact information
Practice address
303 N HURSTBOURNE PKWY, SUITE 200, LOUISVILLE, KY 40222-5185
(502) 412-5847
Mailing address
752 LEISURE LN, GREENWOOD, IN 46142-8319
(317) 851-8087
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31002634A
IN
Other
Enumeration date
02/14/2013
Last updated
02/14/2013
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