MEDICARE: ZACHARY WILLIAM CAMPO

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1932805652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACHARY WILLIAM CAMPO

Provider Business Mailing Address
First Line	:	235 BRIDGE ST APT 2
Second Line	:
City	:	PHOENIXVILLE
State	:	PA
Zip	:	19460-3882
Country	:	US
Telephone Number	:	717-752-6139
Fax Number	:

Provider Business Practice Location Address
First Line	:	409 SECOND AVE STE 203
Second Line	:
City	:	COLLEGEVILLE
State	:	PA
Zip	:	19426-3625
Country	:	US
Telephone Number	:	267-669-0300
Fax Number	:

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

Provider Enumeration Date	:	02/03/2023
Last Update Date	:	02/03/2023

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