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General NPI Number Information
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NPI Number | 1114044856
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Entity Type | Organization
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Legal Business Name | LISA CAMPIONE, D.C.
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 131 E STATE ST
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City | GLOVERSVILLE
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State | NY
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Zip | 12078-1205
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Country | US
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Telephone | 518-725-9355
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Fax | 518-725-9356
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Provider Business Mailing Address
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Address Line | 131 E STATE ST
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City | GLOVERSVILLE
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State | NY
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Zip | 12078-1205
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Country | US
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Telephone | 518-725-9355
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Fax | 518-725-9356
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Authorized Official
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Title or Position | OWNER
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Name | LISA CAMPIONE
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Credential | D.C.
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Telephone | 518-725-9355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X010388
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License Number State | NY
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