MEDICARE: DR. MARLEE DAWN CAMP

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	111N00000X	Chiropractor	2632	TN
2	111N00000X	Chiropractor	1252	MS

General Provider Information

NPI Number	:	1932445731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARLEE DAWN CAMP

Provider Business Mailing Address
First Line	:	125 MAIN ST W
Second Line	:
City	:	NEW ALBANY
State	:	MS
Zip	:	38652-3324
Country	:	US
Telephone Number	:	662-539-7079
Fax Number	:	662-539-7119

Provider Business Practice Location Address
First Line	:	125 MAIN ST W
Second Line	:
City	:	NEW ALBANY
State	:	MS
Zip	:	38652-3324
Country	:	US
Telephone Number	:	662-539-7079
Fax Number	:	662-539-7119

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

Provider Enumeration Date	:	12/25/2012
Last Update Date	:	11/20/2018

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Directions to “ DR. MARLEE DAWN CAMP ” Practice Location

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