Healthcare Provider Details

I. General information

NPI: 1598715807
Provider Name (Legal Business Name): THOMAS JOHN CAULEY MSPT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15288 W BROOKSIDE LN SUITE 131
SURPRISE AZ
85374-3990
US

IV. Provider business mailing address

7200 W BELL RD SUITE F-101
GLENDALE AZ
85308-8529
US

V. Phone/Fax

Practice location:
  • Phone: 623-537-9882
  • Fax: 623-537-9885
Mailing address:
  • Phone: 623-776-9111
  • Fax: 623-776-9115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6466
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: