Provider Demographics
NPI:1376804930
Name:CAMPBELL, RACHEL A
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:A
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SAUNDERS ROAD
Mailing Address - Street 2:
Mailing Address - City:MCADAM
Mailing Address - State:NEW BRUNSWICK
Mailing Address - Zip Code:E6J1L6
Mailing Address - Country:CA
Mailing Address - Phone:506-784-1089
Mailing Address - Fax:
Practice Address - Street 1:4205 FRANKLIN AVE
Practice Address - Street 2:CONCENTRA URGENT CARE
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-6904
Practice Address - Country:US
Practice Address - Phone:254-772-2777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1216502225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist