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General NPI Number Information
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NPI Number | 1548752181
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Entity Type | Individual
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Provider Name | SAMYUKTA KAPPAGANTULA DPT
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Gender | Female
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Dates
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Enumeration Date | 05/30/2018
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 3919 S HIGHWAY 14
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City | GREENVILLE
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State | SC
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Zip | 29615-6138
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Country | US
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Telephone | 864-252-9941
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Fax | 864-252-9609
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Provider Business Mailing Address
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Address Line | PO BOX 96227
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City | PHOENIX
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State | AZ
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Zip | 85072-6227
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Country | US
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Telephone | 678-837-7176
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Fax | 404-777-1311
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 26957
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 12594
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License Number State | SC
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