MEDICARE: CAPITOL AREA PHYSICAL THERAPY ASSOCIATES, 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
1	261QP2000X	Physical Therapy Clinic/Center	5501001463	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	30682	OTHER	MI	BCBS PIN

General Provider Information

NPI Number	:	1730372376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAPITOL AREA PHYSICAL THERAPY ASSOCIATES, INC

Provider Business Mailing Address
First Line	:	PO BOX 558
Second Line	:
City	:	DEWITT
State	:	MI
Zip	:	48820-0558
Country	:	US
Telephone Number	:	517-333-8550
Fax Number	:	517-333-8539

Provider Business Practice Location Address
First Line	:	701 SNOW RD STE A
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48917-4087
Country	:	US
Telephone Number	:	517-323-0593
Fax Number	:	517-323-0002

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. LOUIS P FINOS
Credential	:	P.T.
Telephone Number	:	517-333-8550

Provider Enumeration Date	:	08/27/2007
Last Update Date	:	10/04/2019

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