MEDICARE: MRS. MARSHA KAYE CAMP PT

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	225100000X	Physical Therapist	TN5096	TN
2	2251X0800X	Orthopedic Physical Therapist	PT5096	TN

General Provider Information

NPI Number	:	1104993146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARSHA KAYE CAMP PT

Provider Business Mailing Address
First Line	:	3014 WENTWORTH CT
Second Line	:
City	:	MURFRESSBORO
State	:	TN
Zip	:	37127
Country	:	US
Telephone Number	:	615-542-0057
Fax Number	:	615-907-1832

Provider Business Practice Location Address
First Line	:	1203B MEMORIAL BLVD
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37129-2420
Country	:	US
Telephone Number	:	615-895-4491
Fax Number	:	615-907-1832

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

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	04/10/2013

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