Healthcare Provider Details

I. General information

NPI: 1609437680
Provider Name (Legal Business Name): CAITLIN ROSE GUTHRIE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2019
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 SCOTT CIR
HICKAM AFB HI
96853
US

IV. Provider business mailing address

755 SCOTT CIR
HICKAM AFB HI
96853-5399
US

V. Phone/Fax

Practice location:
  • Phone: 808-448-6137
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-6190-0
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP032372T
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9677
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: