Individual provider · NPI-1

Lisa J Capshaw, PTA

Physical Therapy Assistant · Marietta, GA

NPI number1154761591
StatusActive
Last updated in NPPESJun 30, 2013

Details

NPI
1154761591
Entity type
Individual (NPI-1)
Name
Lisa J Capshaw
Credential
PTA
Sex
Female
Sole proprietor
No
Enumeration date
Jun 30, 2013
Last updated
Jun 30, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225200000X Physical Therapy AssistantPTA000129GAYes

Practice location

1551 Johnson Ferry Rd
Marietta, GA 30062-6438

Phone 770-361-1772

Mailing address

190 Birch Rill Dr
Alpharetta, GA 30022-5025

Phone 404-944-3867

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