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General NPI Number Information
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NPI Number | 1992613053
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Entity Type | Individual
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Provider Name | TRACY VILLALOBOS CAMPOS PT
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Gender | Female
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Dates
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Enumeration Date | 08/31/2026
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Last Update Date | 08/31/2026
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Provider Practice Location Address
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Address Line | 107 SEAGRASS STATION RD
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City | BLUFFTON
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State | SC
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Zip | 29910-9549
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Country | US
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Telephone | 843-836-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 15 CALIBOGUE CAY RD APT 397
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City | HILTON HEAD ISLAND
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State | SC
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Zip | 29928-2938
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Country | US
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Telephone | 843-836-8200
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT.13538
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License Number State | SC
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