Healthcare Provider Details

I. General information

NPI: 1962320382
Provider Name (Legal Business Name): FRANKIE CAMPBELL-PROVO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2243 LEAPHART RD STE C
WEST COLUMBIA SC
29169-4680
US

IV. Provider business mailing address

7001 SAINT ANDREWS RD # 245
COLUMBIA SC
29212-1137
US

V. Phone/Fax

Practice location:
  • Phone: 803-477-1811
  • Fax: 803-407-7705
Mailing address:
  • Phone: 803-477-1811
  • Fax: 803-407-7705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number12301
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: