Provider Demographics
NPI:1043037799
Name:CONNOR, CAITLYN MARIE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:CAITLYN
Middle Name:MARIE
Last Name:CONNOR
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 FOUNTAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:OH
Mailing Address - Zip Code:43138-1585
Mailing Address - Country:US
Mailing Address - Phone:614-653-5272
Mailing Address - Fax:
Practice Address - Street 1:8740 ORION PL
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43240-4053
Practice Address - Country:US
Practice Address - Phone:614-734-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT021342225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist