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Individual

RANDY THOMAS CAPELLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MPT

Contact information

Practice address
15620 EDGEWOOD DR STE 240, BAXTER, MN 56401-6984
(218) 454-7012
Mailing address
500 CROSS ST, BIG STONE CITY, SD 57216-8237
(605) 541-1140
(605) 541-0109

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6725
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6725
MN BOARD OF PHYSICAL THERAPY
MN
Enumeration date
12/04/2014
Last updated
03/07/2022
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