Provider Demographics
NPI:1487084810
Name:PERKINS, CAITLIN
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:PERKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3179 BRAVERTON ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-2665
Mailing Address - Country:US
Mailing Address - Phone:410-956-4308
Mailing Address - Fax:
Practice Address - Street 1:3179 BRAVERTON ST
Practice Address - Street 2:SUITE 201
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-2665
Practice Address - Country:US
Practice Address - Phone:410-956-4308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-21
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24790225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist