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General NPI Number Information
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NPI Number | 1194808659
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Entity Type | Individual
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Provider Name | KATHRYN KAPPUS LPTA
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Gender | Female
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 200 WEST NOME STREET
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City | MARSHALL
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State | AR
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Zip | 72650
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Country | US
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Telephone | 870-448-5732
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 454
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City | LESLIE
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State | AR
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Zip | 72645-0454
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Country | US
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Telephone | 870-447-2939
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA875
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License Number State | AR
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