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NPI Code Detail

MEDICARE: KATHLEEN MARIE CAMPBELL P.T.

MEDICARE: KATHLEEN MARIE CAMPBELL 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
1225100000XPhysical TherapistPT009557OH

General Provider Information

NPI Number : 1932140548
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN MARIE CAMPBELL P.T.
Provider Business Mailing Address
First Line : 27344 WATKIN RD
Second Line :
City : OLMSTED TWP
State : OH
Zip : 44138-1784
Country : US
Telephone Number : 440-427-0599
Fax Number :
Provider Business Practice Location Address
First Line : 3035 WOOSTER RD
Second Line :
City : ROCKY RIVER
State : OH
Zip : 44116-4144
Country : US
Telephone Number : 440-356-9103
Fax Number : 440-333-0910
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2006
Last Update Date : 03/13/2014

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