MEDICARE: JULIE ANN CAMPBELL CHIROPRACTOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH 8491	FL

General Provider Information

NPI Number	:	1104098011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE ANN CAMPBELL CHIROPRACTOR

Provider Business Mailing Address
First Line	:	6309 CORPORATE CT
Second Line	:	STE A
City	:	FORT MYERS
State	:	FL
Zip	:	33919-3538
Country	:	US
Telephone Number	:	239-433-1011
Fax Number	:

Provider Business Practice Location Address
First Line	:	6309 CORPORATE CT
Second Line	:	STE A
City	:	FORT MYERS
State	:	FL
Zip	:	33919-3538
Country	:	US
Telephone Number	:	239-433-1011
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2008
Last Update Date	:	03/31/2008

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