Provider Demographics
NPI:1376091132
Name:CALDRONE, MAEGAN M (PT)
Entity Type:Individual
Prefix:
First Name:MAEGAN
Middle Name:M
Last Name:CALDRONE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MAEGAN
Other - Middle Name:M
Other - Last Name:HARDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:8402 CENTENNIAL PKWY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-4792
Mailing Address - Country:US
Mailing Address - Phone:702-869-3486
Mailing Address - Fax:
Practice Address - Street 1:8402 CENTENNIAL PKWY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-4792
Practice Address - Country:US
Practice Address - Phone:702-869-3486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2282225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist