Provider Demographics
NPI:1033416722
Name:CAMPBELL, MELANIE K (LAC, DIPAC)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:K
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LAC, DIPAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 E JOHNSTOWN RD.
Mailing Address - Street 2:STE C
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230
Mailing Address - Country:US
Mailing Address - Phone:614-584-7989
Mailing Address - Fax:614-534-0633
Practice Address - Street 1:830 E JOHNSTOWN RD.
Practice Address - Street 2:STE C
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230
Practice Address - Country:US
Practice Address - Phone:614-584-7989
Practice Address - Fax:614-534-0633
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH65.000202171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist