MEDICARE: MICHELLE JENNIFER CAMPBELL D.P.T.

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	2251X0800X	Orthopedic Physical Therapist	2129	NV

General Provider Information

NPI Number	:	1437160397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE JENNIFER CAMPBELL D.P.T.

Provider Business Mailing Address
First Line	:	2651 PASEO VERDE PKWY STE 170
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-6616
Country	:	US
Telephone Number	:	702-312-4878
Fax Number	:	702-312-4886

Provider Business Practice Location Address
First Line	:	2651 PASEO VERDE PKWY STE 170
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-6616
Country	:	US
Telephone Number	:	702-312-4878
Fax Number	:	702-312-4886

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

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	11/08/2021

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Directions to “ MICHELLE JENNIFER CAMPBELL D.P.T.” Practice Location

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