Provider Demographics
NPI:1356319230
Name:CAPEL, STEPHEN ANDREW (PT)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ANDREW
Last Name:CAPEL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9480 DOUBLE DIAMOND PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-5844
Mailing Address - Country:US
Mailing Address - Phone:775-786-1600
Mailing Address - Fax:775-786-7706
Practice Address - Street 1:9480 DOUBLE DIAMOND PKWY STE 100
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-5844
Practice Address - Country:US
Practice Address - Phone:775-786-1600
Practice Address - Fax:775-786-7706
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1483225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV103133Medicare PIN