Provider Demographics
NPI:1265889190
Name:BROWNFIELD, CALEB (DPT)
Entity type:Individual
Prefix:
First Name:CALEB
Middle Name:
Last Name:BROWNFIELD
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3552 US ROUTE 60 E
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-1639
Mailing Address - Country:US
Mailing Address - Phone:304-733-9560
Mailing Address - Fax:304-733-1141
Practice Address - Street 1:3552 US ROUTE 60 E
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504-1639
Practice Address - Country:US
Practice Address - Phone:304-733-9560
Practice Address - Fax:304-733-1141
Is Sole Proprietor?:No
Enumeration Date:2016-05-20
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV003619225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist