Provider Demographics
NPI:1699944371
Name:CAPULE, TONI ROSE CRUZ (PT)
Entity type:Individual
Prefix:
First Name:TONI ROSE
Middle Name:CRUZ
Last Name:CAPULE
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 1:5612 MILLRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66218-8409
Mailing Address - Country:US
Mailing Address - Phone:660-888-2411
Mailing Address - Fax:
Practice Address - Street 1:427 W MAIN ST
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:KS
Practice Address - Zip Code:66030-1183
Practice Address - Country:US
Practice Address - Phone:913-856-8747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-03775225100000X
MO2006007041225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist