Provider Demographics
NPI:1215148101
Name:CAPPS, SANDRA ESKEW (PT)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:ESKEW
Last Name:CAPPS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:771 ROCKY BRANCH LN
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-5603
Mailing Address - Country:US
Mailing Address - Phone:706-210-3589
Mailing Address - Fax:
Practice Address - Street 1:987 ST. SEBASTIAN WAY
Practice Address - Street 2:EC-1304
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912
Practice Address - Country:US
Practice Address - Phone:706-721-3574
Practice Address - Fax:706-721-3209
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2851225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist