Healthcare Provider Details

I. General information

NPI: 1548332984
Provider Name (Legal Business Name): DANIELLE LORRAINE CAMP D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 09/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 E PACIFIC AVE
PLEASANTVILLE NJ
08232-1424
US

IV. Provider business mailing address

2 E PACIFIC AVE
PLEASANTVILLE NJ
08232-1424
US

V. Phone/Fax

Practice location:
  • Phone: 609-569-0224
  • Fax: 609-407-2122
Mailing address:
  • Phone: 609-569-0224
  • Fax: 609-407-2122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MCO00526200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: