Provider Demographics
NPI:1255876330
Name:REDDING, CAITLIN CLEMENT (DC)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:CLEMENT
Last Name:REDDING
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 LATOUR AVE
Mailing Address - Street 2:#100
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-7280
Mailing Address - Country:US
Mailing Address - Phone:518-324-5000
Mailing Address - Fax:
Practice Address - Street 1:5 LATOUR AVE
Practice Address - Street 2:#100
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-7280
Practice Address - Country:US
Practice Address - Phone:518-324-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-28
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY70 012907111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor