Provider Demographics
NPI:1972771871
Name:CALDWELL, CASSIE LYNN (DPT)
Entity Type:Individual
Prefix:DR
First Name:CASSIE
Middle Name:LYNN
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:CASSIE
Other - Middle Name:LYNN
Other - Last Name:BYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:101 3RD AVE SW
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-5736
Mailing Address - Country:US
Mailing Address - Phone:319-200-6102
Mailing Address - Fax:319-200-6104
Practice Address - Street 1:101 3RD AVE SW
Practice Address - Street 2:SUITE 102
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-5736
Practice Address - Country:US
Practice Address - Phone:319-200-6102
Practice Address - Fax:319-200-6104
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-13
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA004171225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA004171OtherIOWA PT LICENSE NO
IAIB1213Medicare PIN
IA004171OtherIOWA PT LICENSE NO
IAIB1213031Medicare PIN