Provider Demographics
NPI:1346473949
Name:CAMPBELL, AMANDA HOPE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:HOPE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 TUSCANY LN
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-7949
Mailing Address - Country:US
Mailing Address - Phone:864-993-3302
Mailing Address - Fax:864-227-6047
Practice Address - Street 1:102 TUSCANY LN
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649-7949
Practice Address - Country:US
Practice Address - Phone:864-993-3302
Practice Address - Fax:864-227-6047
Is Sole Proprietor?:No
Enumeration Date:2009-08-29
Last Update Date:2009-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1342225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant