Provider Demographics
NPI:1265452916
Name:CAMPAGNA, CHRISTOPHER VINCENT (MPT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:VINCENT
Last Name:CAMPAGNA
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2056 NEWARK RD
Mailing Address - Street 2:
Mailing Address - City:WEST GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19390-9524
Mailing Address - Country:US
Mailing Address - Phone:610-869-0993
Mailing Address - Fax:610-869-0994
Practice Address - Street 1:2056 NEWARK RD
Practice Address - Street 2:
Practice Address - City:WEST GROVE
Practice Address - State:PA
Practice Address - Zip Code:19390-9524
Practice Address - Country:US
Practice Address - Phone:610-869-0993
Practice Address - Fax:610-869-0994
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017657225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist