Provider Demographics
NPI:1962941625
Name:CALDWELL, JAMES CRAIG (PT, DPT, CSCS, TPI)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:CRAIG
Last Name:CALDWELL
Suffix:
Gender:M
Credentials:PT, DPT, CSCS, TPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 S LAFAYETTE DR APT 212
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-3554
Mailing Address - Country:US
Mailing Address - Phone:714-767-0811
Mailing Address - Fax:
Practice Address - Street 1:315 W SOUTH BOULDER RD STE 100
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1157
Practice Address - Country:US
Practice Address - Phone:303-666-4151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0014585225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist