Healthcare Provider Details

I. General information

NPI: 1619183423
Provider Name (Legal Business Name): THOMAS J CALDWELL PT, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 KENNY RD 3100
COLUMBUS OH
43221-3502
US

IV. Provider business mailing address

1172 FORSYTH LN
GALENA OH
43021-8034
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-2419
  • Fax:
Mailing address:
  • Phone: 740-704-6496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License NumberPT004722
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT002476
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: