Provider Demographics
NPI:1306476007
Name:WHITAKER, CAITLIN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:
Other - Last Name:ARNTSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:203 W SILVER SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:VINEYARD
Mailing Address - State:UT
Mailing Address - Zip Code:84059-6531
Mailing Address - Country:US
Mailing Address - Phone:480-301-2533
Mailing Address - Fax:
Practice Address - Street 1:36397 N GANTZEL RD
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140-7335
Practice Address - Country:US
Practice Address - Phone:480-567-2987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-31098225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist