Healthcare Provider Details

I. General information

NPI: 1801143284
Provider Name (Legal Business Name): KARI CAUDILL DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2012
Last Update Date: 08/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1024 APPLE ST
GREENFIELD IN
46140-1341
US

IV. Provider business mailing address

1024 APPLE ST
GREENFIELD IN
46140-1341
US

V. Phone/Fax

Practice location:
  • Phone: 317-919-4856
  • Fax:
Mailing address:
  • Phone: 317-919-4856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number13822
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: