Provider Demographics
NPI:1598164956
Name:CALDWELL, CAITLYN REX (DPT)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:REX
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CAITLYN
Other - Middle Name:A
Other - Last Name:REX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2100 N ASPEN AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-1490
Mailing Address - Country:US
Mailing Address - Phone:918-505-7575
Mailing Address - Fax:
Practice Address - Street 1:2100 N ASPEN AVE
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-1490
Practice Address - Country:US
Practice Address - Phone:918-505-7575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-21
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4831225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist