Basic Information
| Provider Information | |||||||||
| NPI: | 1740821305 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCBRYDE | ||||||||
| FirstName: | CAITLIN | ||||||||
| MiddleName: | OLIVER | ||||||||
| NamePrefix: | |||||||||
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| Credential: | PT, DPT | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | OLIVER | ||||||||
| OtherFirstName: | CAITLIN | ||||||||
| OtherMiddleName: | RENEE' | ||||||||
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| OtherCredential: | PT, DPT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 8205 PRESIDENTS DR | ||||||||
| Address2: | |||||||||
| City: | HUMMELSTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170368621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178392159 | ||||||||
| FaxNumber: | 7175651104 | ||||||||
| Practice Location | |||||||||
| Address1: | 831 1ST ST N STE B | ||||||||
| Address2: | |||||||||
| City: | ALABASTER | ||||||||
| State: | AL | ||||||||
| PostalCode: | 350078944 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053589138 | ||||||||
| FaxNumber: | 2053589139 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2019 | ||||||||
| LastUpdateDate: | 10/31/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PTH6926 | AL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.