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Individual

MRS. MARY LINDA CAPUTO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CSA

Contact information

Practice address
1945 SCOTTSVILLE RD, B2 PMB 137, BOWLING GREEN, KY 42104-3376
(270) 782-0434
Mailing address
18320 CHERRYWOOD DRIVE, CATLETTSBURG, KY 41129-4210
(270) 782-0434
(270) 782-0564

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
SA007
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007
KCSA
KY
Enumeration date
01/16/2007
Last updated
07/08/2007
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