Provider Demographics
NPI:1982638458
Name:CAPANNOLA, MARC DAVID (PT)
Entity Type:Individual
Prefix:MR
First Name:MARC
Middle Name:DAVID
Last Name:CAPANNOLA
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:984-215-4110
Mailing Address - Fax:
Practice Address - Street 1:1120 SE CARY PKWY STE 101
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7413
Practice Address - Country:US
Practice Address - Phone:919-467-7801
Practice Address - Fax:919-235-3399
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2021-05-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NCP6738225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1080HOtherBCBS PROVIDER NUMBER