Provider Demographics
NPI:1124283452
Name:SLATER, CALEB E (PT)
Entity type:Individual
Prefix:MR
First Name:CALEB
Middle Name:E
Last Name:SLATER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:CALEB
Other - Middle Name:
Other - Last Name:KNIPPENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1699 BETHLEHEM PIKE
Mailing Address - Street 2:# 3
Mailing Address - City:HATFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19440-1302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1691 BETHLEHEM PIKE
Practice Address - Street 2:
Practice Address - City:HATFIELD
Practice Address - State:PA
Practice Address - Zip Code:19440-1302
Practice Address - Country:US
Practice Address - Phone:267-308-5330
Practice Address - Fax:267-308-5331
Is Sole Proprietor?:No
Enumeration Date:2008-07-25
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0216672251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ124931Medicare PIN