Provider Demographics
NPI:1184817728
Name:CAPITOL AREA PHYSICAL THERAPY ASSOCIATES, INC
Entity Type:Organization
Organization Name:CAPITOL AREA PHYSICAL THERAPY ASSOCIATES, INC
Other - Org Name:FYZICAL THERAPY MID-MICHIGAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:P
Authorized Official - Last Name:FINOS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:517-333-8550
Mailing Address - Street 1:PO BOX 558
Mailing Address - Street 2:
Mailing Address - City:DEWITT
Mailing Address - State:MI
Mailing Address - Zip Code:48820-0558
Mailing Address - Country:US
Mailing Address - Phone:517-333-8550
Mailing Address - Fax:517-333-8539
Practice Address - Street 1:12800 ESCANABA DR
Practice Address - Street 2:SUITE 3
Practice Address - City:DEWITT
Practice Address - State:MI
Practice Address - Zip Code:48820-8680
Practice Address - Country:US
Practice Address - Phone:517-333-8550
Practice Address - Fax:517-333-8539
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAPITOL AREA PHYSICAL THERAPY ASSOCIATES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-27
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501001463261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI30683OtherBCBS PIN
MI236664Medicare Oscar/Certification