Healthcare Provider Details

I. General information

NPI: 1235113879
Provider Name (Legal Business Name): CAITLIN SPRINGER PT, PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 09/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST, WHITE 1
BOSTON MA
02114
US

IV. Provider business mailing address

55 FRUIT ST, WHITE 1
BOSTON MA
02114
US

V. Phone/Fax

Practice location:
  • Phone: 617-724-4100
  • Fax: 617-726-7415
Mailing address:
  • Phone: 617-724-4100
  • Fax: 617-726-7415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number16887
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA5151
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: