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NPI Code Detail

MEDICARE: MR. ZACH JAMES DECAMP I PTA

MEDICARE: MR. ZACH JAMES DECAMP I PTA
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
1225200000XPhysical Therapy AssistantPTA012793OH

General Provider Information

NPI Number : 1518821347
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ZACH JAMES DECAMP I PTA
Provider Business Mailing Address
First Line : 4949 GREENGATE DR
Second Line :
City : GROVEPORT
State : OH
Zip : 43125-9753
Country : US
Telephone Number : 614-460-0647
Fax Number :
Provider Business Practice Location Address
First Line : 402 LIBERTY WAY
Second Line :
City : GAHANNA
State : OH
Zip : 43230-3502
Country : US
Telephone Number : 614-460-0647
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2025
Last Update Date : 12/15/2025

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