Provider Demographics
NPI:1710864129
Name:SUTHERLAND, CALLUM PATRICK (DPT)
Entity type:Individual
Prefix:
First Name:CALLUM
Middle Name:PATRICK
Last Name:SUTHERLAND
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 1:1872 PURDIE LN
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-3129
Mailing Address - Country:US
Mailing Address - Phone:267-449-6033
Mailing Address - Fax:
Practice Address - Street 1:645 N JESSICA BROOKE CIR
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7333
Practice Address - Country:US
Practice Address - Phone:907-631-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT033517225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist