Provider Demographics
NPI:1548099955
Name:KAPPNER, GRACE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:GRACE
Middle Name:
Last Name:KAPPNER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 HICKORY DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47542-9498
Mailing Address - Country:US
Mailing Address - Phone:812-639-8492
Mailing Address - Fax:
Practice Address - Street 1:301 SATORI PKWY
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-6406
Practice Address - Country:US
Practice Address - Phone:317-272-4186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05015230A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist