Individual
CHERYL L CALDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
595 PETERSON DR, PHILLIPS, WI 54555-1418
(715) 339-3113
Mailing address
PO BOX 474, ABBOTSFORD, WI 54405-0474
(715) 223-4634
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
555-19
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4034500
—
WI
Enumeration date
03/26/2007
Last updated
11/05/2012
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