Provider Demographics
NPI:1033094222
Name:MATTOCKS, CAITLYN ROSE (DPT)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:ROSE
Last Name:MATTOCKS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1599 N HERMITAGE RD
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-3180
Mailing Address - Country:US
Mailing Address - Phone:724-962-7920
Mailing Address - Fax:724-962-6029
Practice Address - Street 1:139 N ERIE ST STE 1
Practice Address - Street 2:
Practice Address - City:MERCER
Practice Address - State:PA
Practice Address - Zip Code:16137-1285
Practice Address - Country:US
Practice Address - Phone:724-662-1776
Practice Address - Fax:724-662-1858
Is Sole Proprietor?:No
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT033645225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist