Provider Demographics
NPI:1134322092
Name:CAMP, CHELBE L (LMT)
Entity Type:Individual
Prefix:MRS
First Name:CHELBE
Middle Name:L
Last Name:CAMP
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6393 W GLORY HILL ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:FL
Mailing Address - Zip Code:34465-2769
Mailing Address - Country:US
Mailing Address - Phone:352-746-6987
Mailing Address - Fax:
Practice Address - Street 1:2027 N DONOVAN AVE
Practice Address - Street 2:SUITE A
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34428-7887
Practice Address - Country:US
Practice Address - Phone:352-795-9679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA50301225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist