=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154236719
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MR. SANDERS CAPERS JR.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2026
-----------------------------------------------------
Last Update Date | 08/18/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2598 PASS TOAD
-----------------------------------------------------
City | BILOXI
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39531-2713
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 769-926-0621
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2013 CLEMSON CIR
-----------------------------------------------------
City | GAUTIER
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39553-6607
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | 2455
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------