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NPI Code Detail

MEDICARE: MRS. ERIN L CAMPBELL OTRL

MEDICARE: MRS. ERIN L CAMPBELL OTRL
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
1225X00000XOccupational Therapist5237NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111313122OTHERNCCAQH

General Provider Information

NPI Number : 1124064217
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ERIN L CAMPBELL OTRL
Provider Business Mailing Address
First Line : 17121 CLEMENTINE CT
Second Line :
City : CHARLOTTE
State : NC
Zip : 28277-2496
Country : US
Telephone Number : 704-641-7193
Fax Number :
Provider Business Practice Location Address
First Line : 5700 EXECUTIVE CENTER DR
Second Line : SUITE 115
City : CHARLOTTE
State : NC
Zip : 28212-8858
Country : US
Telephone Number : 704-566-6040
Fax Number : 704-525-9337
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. ERIN L CAMPBELL OTRL” Practice Location

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