MEDICARE: MR. MATTHEW DIRK CAPPIS 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	805	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558429878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MATTHEW DIRK CAPPIS P.T.

Provider Business Mailing Address
First Line	:	PO BOX 1546
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59403-1546
Country	:	US
Telephone Number	:	406-727-2739
Fax Number	:	406-453-0959

Provider Business Practice Location Address
First Line	:	3511 1ST AVE N
Second Line	:	SUITE 3
City	:	GREAT FALLS
State	:	MT
Zip	:	59401-3527
Country	:	US
Telephone Number	:	406-727-2739
Fax Number	:	406-453-0959

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

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	08/23/2010

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Directions to “ MR. MATTHEW DIRK CAPPIS P.T.” Practice Location

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