Provider Demographics
NPI:1194808659
Name:KAPPUS, KATHRYN (LPTA)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:
Last Name:KAPPUS
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 454
Mailing Address - Street 2:
Mailing Address - City:LESLIE
Mailing Address - State:AR
Mailing Address - Zip Code:72645-0454
Mailing Address - Country:US
Mailing Address - Phone:870-447-2939
Mailing Address - Fax:
Practice Address - Street 1:200 WEST NOME STREET
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:AR
Practice Address - Zip Code:72650
Practice Address - Country:US
Practice Address - Phone:870-448-5732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPTA875225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant