Provider Demographics
NPI:1114058393
Name:CAMP CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:CAMP CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRACTICIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:302-378-5110
Mailing Address - Street 1:272 CARTER DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-5852
Mailing Address - Country:US
Mailing Address - Phone:302-378-5110
Mailing Address - Fax:302-378-4996
Practice Address - Street 1:272 CARTER DR
Practice Address - Street 2:SUITE 120
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-5852
Practice Address - Country:US
Practice Address - Phone:302-378-5110
Practice Address - Fax:302-378-4996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000319111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty