Individual
SHAYNE MATTHEW CAPONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1568 LAKE LANSING RD STE B, LANSING, MI 48912-3707
(517) 483-2734
Mailing address
1568 LAKE LANSING RD STE B, LANSING, MI 48912-3707
(517) 483-2734
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502005446
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5502005446
—
MI
Enumeration date
02/04/2019
Last updated
02/04/2019
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