Provider Demographics
NPI:1053381350
Name:CAPRA, LINDA M (DC)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:M
Last Name:CAPRA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 MAIN ST E
Mailing Address - Street 2:
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751-2753
Mailing Address - Country:US
Mailing Address - Phone:715-235-7333
Mailing Address - Fax:715-235-8597
Practice Address - Street 1:815 MAIN ST E
Practice Address - Street 2:
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751-2753
Practice Address - Country:US
Practice Address - Phone:715-235-7333
Practice Address - Fax:715-235-8597
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2763-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38865200Medicaid