Healthcare Provider Details

I. General information

NPI: 1710010525
Provider Name (Legal Business Name): CAMP CHIROPRACTIC CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 07/26/2010
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 Number38MC00526200
License Number StateNJ

VIII. Authorized Official

Name: DR. DANIELLE LORRAINE CAMP
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 609-569-0224