Provider Demographics
NPI:1508835836
Name:D'AMATO, CAMILLE T (DC)
Entity Type:Individual
Prefix:DR
First Name:CAMILLE
Middle Name:T
Last Name:D'AMATO
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 1:6231 LEESBURG PIKE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-2102
Mailing Address - Country:US
Mailing Address - Phone:703-237-0404
Mailing Address - Fax:703-237-7828
Practice Address - Street 1:6231 LEESBURG PIKE
Practice Address - Street 2:SUITE 201
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2102
Practice Address - Country:US
Practice Address - Phone:703-237-0404
Practice Address - Fax:703-237-7828
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1065111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician