Provider Demographics
NPI:1629280474
Name:CAPLES, TINA C (PT)
Entity Type:Individual
Prefix:MRS
First Name:TINA
Middle Name:C
Last Name:CAPLES
Suffix:
Gender:F
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:PO BOX 765
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:AL
Mailing Address - Zip Code:35121-0026
Mailing Address - Country:US
Mailing Address - Phone:205-274-8730
Mailing Address - Fax:
Practice Address - Street 1:150 GILBREATH DR
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:AL
Practice Address - Zip Code:35121-2827
Practice Address - Country:US
Practice Address - Phone:205-274-8730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH 2161225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510-95485OtherMCEBCBS
AL515-06865OtherSCRBCBS
AL515-06867OtherMCB BCBS
AL510-95485OtherMCEBCBS