Provider Demographics
NPI:1215099940
Name:CAPPETTO, GLORIA R (DIPL AC, L AC)
Entity type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:R
Last Name:CAPPETTO
Suffix:
Gender:F
Credentials:DIPL AC, L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1371 N WILL ROGERS DR
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81007-2339
Mailing Address - Country:US
Mailing Address - Phone:719-778-6040
Mailing Address - Fax:
Practice Address - Street 1:44 E SPAULDING AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:PUEBLO WEST
Practice Address - State:CO
Practice Address - Zip Code:81007-1668
Practice Address - Country:US
Practice Address - Phone:719-778-6040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.000686171100000X
CO1250171100000X
COACU0001250171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist