Provider Demographics
NPI:1699000232
Name:CAMPBELL, CARLA BETH (LPT)
Entity Type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:BETH
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5760 FRESH MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-9018
Mailing Address - Country:US
Mailing Address - Phone:610-398-8373
Mailing Address - Fax:
Practice Address - Street 1:1925 W TURNER ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-5513
Practice Address - Country:US
Practice Address - Phone:610-794-5262
Practice Address - Fax:610-794-5457
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT001718E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist