Healthcare Provider Details

I. General information

NPI: 1770622250
Provider Name (Legal Business Name): KATE LYNN CAMPBELL DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 04/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 ROUTE 37
NEW FAIRFIELD CT
06812
US

IV. Provider business mailing address

20 RITA RD
RIDGEFIELD CT
06877-2238
US

V. Phone/Fax

Practice location:
  • Phone: 203-312-0211
  • Fax: 203-312-0201
Mailing address:
  • Phone: 203-431-1493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: