Provider Demographics
NPI:1205211281
Name:DOERFLEIN, CAITLIN ELISE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:ELISE
Last Name:DOERFLEIN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MS
Other - First Name:CAITLIN
Other - Middle Name:ELISE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:120 LEGGETT ST
Mailing Address - Street 2:APT B7
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-2472
Mailing Address - Country:US
Mailing Address - Phone:618-499-0667
Mailing Address - Fax:
Practice Address - Street 1:120 LEGGETT ST
Practice Address - Street 2:APT B7
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-2472
Practice Address - Country:US
Practice Address - Phone:618-499-0667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-20
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPTA 3976225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant