Provider Demographics
NPI:1235449406
Name:CAMPOT, YVETTE (LMT)
Entity Type:Individual
Prefix:MISS
First Name:YVETTE
Middle Name:
Last Name:CAMPOT
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 1:373 GRANITE ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4955
Mailing Address - Country:US
Mailing Address - Phone:781-630-0081
Mailing Address - Fax:617-657-6799
Practice Address - Street 1:373 GRANITE ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4955
Practice Address - Country:US
Practice Address - Phone:781-630-0081
Practice Address - Fax:617-657-6799
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7474173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist