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NPI Code Detail

MEDICARE: TESSA L CAPELLE P.T.

MEDICARE: TESSA L CAPELLE P.T.
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
1225100000XPhysical Therapist6728MN

General Provider Information

NPI Number : 1366628067
Entity Type Code : Individual
Provider Name (Legal Business Name) : TESSA L CAPELLE P.T.
Provider Business Mailing Address
First Line : 24313 WILD WINGS WAY
Second Line :
City : NISSWA
State : MN
Zip : 56468-2481
Country : US
Telephone Number : 218-232-1973
Fax Number :
Provider Business Practice Location Address
First Line : 804 OAK ST
Second Line :
City : BRAINERD
State : MN
Zip : 56401-3755
Country : US
Telephone Number : 218-454-5500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2008
Last Update Date : 03/20/2026

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Directions to “ TESSA L CAPELLE P.T.” Practice Location

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