Provider Demographics
NPI:1437363231
Name:MCBRIDE-KAPALCHIK, PATTI C (LMT)
Entity Type:Individual
Prefix:MRS
First Name:PATTI
Middle Name:C
Last Name:MCBRIDE-KAPALCHIK
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:929 N SPRING GARDEN AVE
Mailing Address - Street 2:#100
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-0900
Mailing Address - Country:US
Mailing Address - Phone:386-734-2592
Mailing Address - Fax:386-734-1773
Practice Address - Street 1:929 N SPRING GARDEN AVE
Practice Address - Street 2:#100
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-0900
Practice Address - Country:US
Practice Address - Phone:386-734-2592
Practice Address - Fax:386-734-1773
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA32148225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist