Provider Demographics
NPI:1407814841
Name:CAMPEAU, SUSAN MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:MARIE
Last Name:CAMPEAU
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1074
Mailing Address - Street 2:
Mailing Address - City:SILER CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27344-1074
Mailing Address - Country:US
Mailing Address - Phone:919-742-5306
Mailing Address - Fax:919-742-5306
Practice Address - Street 1:110 VILLAGE LAKE RD
Practice Address - Street 2:SUITE C
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-1821
Practice Address - Country:US
Practice Address - Phone:919-742-5306
Practice Address - Fax:919-742-5306
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2948111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor