Provider Demographics
NPI:1467987750
Name:NORMAN, CALEB CHARLES (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:CALEB
Middle Name:CHARLES
Last Name:NORMAN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5295 STONE MOUNTAIN HWY STE I
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-3439
Mailing Address - Country:US
Mailing Address - Phone:770-879-5646
Mailing Address - Fax:770-981-2024
Practice Address - Street 1:2144 PEACHTREE ROAD
Practice Address - Street 2:725
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3030
Practice Address - Country:US
Practice Address - Phone:985-320-8243
Practice Address - Fax:985-320-8243
Is Sole Proprietor?:No
Enumeration Date:2017-04-25
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT012136225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist