Provider Demographics
NPI:1346631587
Name:CAPSTONE THERAPY, LLC
Entity Type:Organization
Organization Name:CAPSTONE THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:RANDAL
Authorized Official - Last Name:WINKELMANN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:918-292-8886
Mailing Address - Street 1:9810 E 42ND ST
Mailing Address - Street 2:SUITE 226
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74146-3653
Mailing Address - Country:US
Mailing Address - Phone:918-292-8886
Mailing Address - Fax:
Practice Address - Street 1:9810 E 42ND ST
Practice Address - Street 2:SUITE 226
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-3653
Practice Address - Country:US
Practice Address - Phone:918-292-8886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-10
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2377225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty