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General NPI Number Information
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NPI Number | 1760927289
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Entity Type | Individual
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Provider Name | CARINA CHAMPAGNE DPT
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Gender | Female
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Dates
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Enumeration Date | 12/20/2016
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Last Update Date | 12/20/2016
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Provider Practice Location Address
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Address Line | 21 N MAIN ST
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City | ATTLEBORO
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State | MA
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Zip | 02703-2217
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Country | US
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Telephone | 508-226-2326
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Fax | 508-431-2637
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Provider Business Mailing Address
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Address Line | 281 COUNTY ST
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City | ATTLEBORO
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State | MA
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Zip | 02703-3511
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Country | US
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Telephone | 508-226-2326
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Fax | 508-431-2637
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 187406
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License Number State | MA
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