Caleb Hugh Capshaw

Individual provider Active NPI Physical Therapy Assistant · Pulaski, TN

NPI 1235685348 · NPPES record last updated Aug 29, 2016

Key facts

NPI
1235685348
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
6309 (TN)
Practice address
203 Village SQ
Pulaski, TN 38478-2929
Phone
(931) 424-5588
Fax
(931) 424-5590
NPI assigned
Aug 29, 2016
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6309TNMDPhysician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 6309 TN Yes

Addresses

Primary practice location

203 Village SQ
Pulaski, TN 38478-2929

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

Other providers in Pulaski, TN

All providers in Pulaski, TN · Physical Therapy Assistant in Tennessee

Sources for this page

Verify at the official NPI Registry.