Provider Demographics
NPI:1720606213
Name:CAUDILL, CALEB (DC)
Entity Type:Individual
Prefix:DR
First Name:CALEB
Middle Name:
Last Name:CAUDILL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13605 GENITO RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-4001
Mailing Address - Country:US
Mailing Address - Phone:804-464-5478
Mailing Address - Fax:
Practice Address - Street 1:13605 GENITO RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-4001
Practice Address - Country:US
Practice Address - Phone:804-464-5478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-10
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104557687111N00000X
NC5131111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor