MEDICARE: BRIAN A CAMPBELL DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH6314	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073519096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN A CAMPBELL DC

Provider Business Mailing Address
First Line	:	1025 N CONGRESS AVE
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-5144
Country	:	US
Telephone Number	:	561-689-2900
Fax Number	:	561-689-1964

Provider Business Practice Location Address
First Line	:	1025 N CONGRESS AVE
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-5144
Country	:	US
Telephone Number	:	561-689-2900
Fax Number	:	561-689-1964

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	07/15/2008

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Directions to “ BRIAN A CAMPBELL DC” Practice Location

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