Provider Demographics
NPI:1154832715
Name:CAALAMAN, LESTER IAN
Entity Type:Individual
Prefix:
First Name:LESTER IAN
Middle Name:
Last Name:CAALAMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4880 KERRY LYNN VW UNIT 205
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80922-5662
Mailing Address - Country:US
Mailing Address - Phone:719-937-3645
Mailing Address - Fax:
Practice Address - Street 1:4880 KERRY LYNN VW UNIT 205
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80922-5662
Practice Address - Country:US
Practice Address - Phone:719-937-3645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-22
Last Update Date:2017-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10780225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist