Individual
PHILLIP SAMUEL CAPES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNIM
Contact information
Practice address
1300 OAKRIDGE DR, SUITE 130, FORT COLLINS, CO 80525-5564
(866) 740-9640
Mailing address
45 PECAN LN, OXFORD, GA 30054-3862
(770) 380-3190
Taxonomy
Speciality
Code
Description
License number
State
246ZE0500X
EEG Specialist/Technologist
1220
GA
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
1220
GA
2472E0500X
EEG Technician
1220
GA
Other
Enumeration date
05/24/2011
Last updated
05/24/2011
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