Provider Demographics
NPI:1639289408
Name:KAPASI, MANISHA Z (PT PHD CHT)
Entity Type:Individual
Prefix:MRS
First Name:MANISHA
Middle Name:Z
Last Name:KAPASI
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Gender:F
Credentials:PT PHD CHT
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Mailing Address - Street 1:10700 MEDLOCK BRIDGE RD
Mailing Address - Street 2:STE 105
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097
Mailing Address - Country:US
Mailing Address - Phone:770-623-0105
Mailing Address - Fax:770-623-0602
Practice Address - Street 1:10700 MEDLOCK BRIDGE RD
Practice Address - Street 2:STE 105
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097
Practice Address - Country:US
Practice Address - Phone:770-612-0105
Practice Address - Fax:770-223-0602
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-06-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA1609225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA65BBBMFMedicare PIN