Provider Demographics
NPI:1538695275
Name:CAYLAN, HENRY
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:
Last Name:CAYLAN
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 1:12266 TWYCKENHAM DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-4501
Mailing Address - Country:US
Mailing Address - Phone:917-703-5916
Mailing Address - Fax:
Practice Address - Street 1:12266 TWYCKENHAM DR
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-4501
Practice Address - Country:US
Practice Address - Phone:917-703-5916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05007144A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist