Provider Demographics
NPI:1245762244
Name:CALDWELL, JOHN F (LMT)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:CALDWELL
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 DELAWARE AVE
Mailing Address - Street 2:REAR
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-1601
Mailing Address - Country:US
Mailing Address - Phone:585-748-0594
Mailing Address - Fax:
Practice Address - Street 1:369 DELAWARE AVE
Practice Address - Street 2:REAR
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-1601
Practice Address - Country:US
Practice Address - Phone:585-748-0594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027828225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist