Provider Demographics
NPI:1629517164
Name:CALDWELL, BETSEY (DPT)
Entity Type:Individual
Prefix:MS
First Name:BETSEY
Middle Name:
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BETSEY
Other - Middle Name:
Other - Last Name:STEC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:715 S LAFAYETTE DR
Mailing Address - Street 2:APT 212
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-3581
Mailing Address - Country:US
Mailing Address - Phone:616-328-9545
Mailing Address - Fax:
Practice Address - Street 1:335 W SOUTH BOULDER RD
Practice Address - Street 2:SUITE 1
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1196
Practice Address - Country:US
Practice Address - Phone:303-954-8423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-16
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL0014609225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist