Provider Demographics
NPI:1497648935
Name:CAPELLAN, MARILEE (DPT)
Entity type:Individual
Prefix:
First Name:MARILEE
Middle Name:
Last Name:CAPELLAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 FOREMAN DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-4290
Mailing Address - Country:US
Mailing Address - Phone:561-460-9051
Mailing Address - Fax:
Practice Address - Street 1:3651 MARS HILL RD STE 350A
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-8501
Practice Address - Country:US
Practice Address - Phone:706-389-5199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT017471225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty