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
1	225100000X	Physical Therapist	6728	MN

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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