Provider Demographics
NPI:1659659423
Name:VANCAMP, CYNTHIA KLUTTZ (QP)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:KLUTTZ
Last Name:VANCAMP
Suffix:
Gender:F
Credentials:QP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 PEE DEE AVE
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-4932
Mailing Address - Country:US
Mailing Address - Phone:704-986-7255
Mailing Address - Fax:704-986-6375
Practice Address - Street 1:350 PEE DEE AVE
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-4932
Practice Address - Country:US
Practice Address - Phone:704-986-7255
Practice Address - Fax:704-986-6375
Is Sole Proprietor?:No
Enumeration Date:2011-07-28
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator