Organization
SUSAN CAPPELLI PT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN CAPPELLI MPT (MANAGING MEMBER)
(601) 416-5715
Entity
Organization
Contact information
Practice address
7597 ATTALA ROAD 5216, KOSCIUSKO, MS 39090-6401
(601) 416-5715
Mailing address
7597 ATTALA ROAD 5216, KOSCIUSKO, MS 39090-6401
(601) 416-5715
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
PT3473
MS
251E00000X
Home Health Agency
PT3473
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015950
—
MS
Enumeration date
07/28/2007
Last updated
07/28/2007
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