Provider Demographics
NPI:1871249649
Name:BUNTING, CALEB THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:CALEB
Middle Name:THOMAS
Last Name:BUNTING
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 1:13 11TH ST
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-3841
Mailing Address - Country:US
Mailing Address - Phone:615-225-7186
Mailing Address - Fax:
Practice Address - Street 1:2800 N 5TH ST # 302
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-1837
Practice Address - Country:US
Practice Address - Phone:904-217-6894
Practice Address - Fax:904-788-7481
Is Sole Proprietor?:No
Enumeration Date:2022-03-01
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH13954111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor