Provider Demographics
NPI:1588080444
Name:CAPPELLI, SUSAN ORI (LAT, ATC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:ORI
Last Name:CAPPELLI
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1282 SUMMIT WAY
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-2680
Mailing Address - Country:US
Mailing Address - Phone:717-991-9922
Mailing Address - Fax:
Practice Address - Street 1:1282 SUMMIT WAY
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-2680
Practice Address - Country:US
Practice Address - Phone:717-991-9922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART001310A174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist