Provider Demographics
NPI:1619418795
Name:MOTSINGER, CAMERON (ATC)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:
Last Name:MOTSINGER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:994 STONO RIVER DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-8633
Mailing Address - Country:US
Mailing Address - Phone:919-622-4902
Mailing Address - Fax:
Practice Address - Street 1:994 STONO RIVER DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-8633
Practice Address - Country:US
Practice Address - Phone:919-622-4902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2000017641405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes405300000XOther Service ProvidersPrevention Professional