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NPI Code Detail

MEDICARE: CAPITOL PHYSICAL THERAPY CENTER INC

MEDICARE: CAPITOL PHYSICAL THERAPY CENTER INC
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 Therapist
2261QP2000XPhysical Therapy Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ZZZ46010ZOTHERCABLUE SHIELD

General Provider Information

NPI Number : 1649288648
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAPITOL PHYSICAL THERAPY CENTER INC
Provider Business Mailing Address
First Line : 2288 AUBURN BLVD STE 107
Second Line :
City : SACRAMENTO
State : CA
Zip : 95821-1619
Country : US
Telephone Number : 916-446-1497
Fax Number : 916-446-5959
Provider Business Practice Location Address
First Line : 2288 AUBURN BLVD STE 107
Second Line :
City : SACRAMENTO
State : CA
Zip : 95821-1619
Country : US
Telephone Number : 916-446-1497
Fax Number : 916-446-5959
Authorized Official
Title or Position : OWNER PHYSICAL THERAPIST
Name : MRS. ALYSA KOREEN CAULFIELD
Credential : PT DPT
Telephone Number : 916-446-1497
Provider Enumeration Date : 08/04/2006
Last Update Date : 10/22/2019

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Directions to “CAPITOL PHYSICAL THERAPY CENTER INC ” Practice Location

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