Provider Demographics
NPI:1528256575
Name:CALHOUN, JANELLE RICOLE (PT)
Entity type:Individual
Prefix:MRS
First Name:JANELLE
Middle Name:RICOLE
Last Name:CALHOUN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 542485
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-2485
Mailing Address - Country:US
Mailing Address - Phone:214-533-4338
Mailing Address - Fax:972-264-0165
Practice Address - Street 1:201 DEVONSHIRE DR
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-3518
Practice Address - Country:US
Practice Address - Phone:214-533-4338
Practice Address - Fax:972-264-0165
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1171068225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist