Provider Demographics
NPI:1477225431
Name:CAMPBELL, KAYLA DAWN (DPT)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:DAWN
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:DAWN
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 1014
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-1014
Mailing Address - Country:US
Mailing Address - Phone:732-855-9751
Mailing Address - Fax:732-855-9755
Practice Address - Street 1:1574 ROUTE 23 STE C
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:NJ
Practice Address - Zip Code:07405-1897
Practice Address - Country:US
Practice Address - Phone:973-291-8880
Practice Address - Fax:973-291-8881
Is Sole Proprietor?:No
Enumeration Date:2021-09-29
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02028500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist