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NPI Code Detail

MEDICARE: MS. TESSA MARIE CAMPBELL DPT

MEDICARE:  MS. TESSA MARIE CAMPBELL  DPT
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
1225100000XPhysical Therapist2890NV

General Provider Information

NPI Number : 1124442710
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TESSA MARIE CAMPBELL DPT
Provider Business Mailing Address
First Line : 4215 S GRAND CANYON DR STE 101
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147-7173
Country : US
Telephone Number : 702-448-6042
Fax Number : 702-430-8970
Provider Business Practice Location Address
First Line : 4215 S GRAND CANYON DR STE 101
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147
Country : US
Telephone Number : 702-480-6042
Fax Number : 702-702-4308
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2014
Last Update Date : 06/21/2018

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Directions to “ MS. TESSA MARIE CAMPBELL DPT” Practice Location

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