MEDICARE: MRS. AMANDA MARIE CAPPATT DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT023408	PA
2	225100000X	Physical Therapist	DAPT003884	PA

General Provider Information

NPI Number	:	1285147116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMANDA MARIE CAPPATT DPT

Provider Business Mailing Address
First Line	:	539 GREENFIELD AVE
Second Line	:
City	:	PGH
State	:	PA
Zip	:	15207-1091
Country	:	US
Telephone Number	:	412-421-2222
Fax Number	:	412-421-2227

Provider Business Practice Location Address
First Line	:	539 GREENFIELD AVE
Second Line	:
City	:	PGH
State	:	PA
Zip	:	15207-1091
Country	:	US
Telephone Number	:	412-421-2222
Fax Number	:	412-421-2227

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2017
Last Update Date	:	11/14/2017

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