Provider Demographics
NPI:1699024299
Name:EVANS, CAITLIN BELTER (DPT, PT, ATC)
Entity Type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:BELTER
Last Name:EVANS
Suffix:
Gender:F
Credentials:DPT, PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 CORNWALL HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:WEST CORNWALL
Mailing Address - State:CT
Mailing Address - Zip Code:06796-1617
Mailing Address - Country:US
Mailing Address - Phone:860-748-3791
Mailing Address - Fax:
Practice Address - Street 1:327 MAIN ST
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:CT
Practice Address - Zip Code:06039-1205
Practice Address - Country:US
Practice Address - Phone:860-748-3791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39481225100000X
CT009473225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist