Provider Demographics
NPI:1124368972
Name:KAPATOS, PHILIP DANIEL (PT, DPT, GCS)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:DANIEL
Last Name:KAPATOS
Suffix:
Gender:M
Credentials:PT, DPT, GCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 REBANNA RD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01473-1169
Mailing Address - Country:US
Mailing Address - Phone:716-982-5536
Mailing Address - Fax:
Practice Address - Street 1:2817 REILLY ST
Practice Address - Street 2:
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-5437
Practice Address - Country:US
Practice Address - Phone:910-907-8922
Practice Address - Fax:910-907-9069
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-14
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24458225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist