Provider Demographics
NPI:1255070876
Name:GREGORY, CAITLIN (DPT)
Entity type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:
Last Name:GREGORY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 LILLYPAD LN
Mailing Address - Street 2:
Mailing Address - City:HAWLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18428-7758
Mailing Address - Country:US
Mailing Address - Phone:570-851-8562
Mailing Address - Fax:
Practice Address - Street 1:1564 ROUTE 507 STE C
Practice Address - Street 2:
Practice Address - City:GREENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18426-4502
Practice Address - Country:US
Practice Address - Phone:570-676-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
PAPT030751225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist