Provider Demographics
NPI:1851957575
Name:KAPEC, CAMERON MACKENZIE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:MACKENZIE
Last Name:KAPEC
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SPRING OAK CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-1817
Mailing Address - Country:US
Mailing Address - Phone:336-682-0104
Mailing Address - Fax:
Practice Address - Street 1:233 BELL FORK RD STE E
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-6471
Practice Address - Country:US
Practice Address - Phone:910-238-2259
Practice Address - Fax:888-209-9322
Is Sole Proprietor?:No
Enumeration Date:2019-05-17
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9581225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist