Provider Demographics
NPI:1699385955
Name:CAMPBELL, AIMEE (PT)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1323 COUNTY ROAD 61
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:OH
Mailing Address - Zip Code:43314-9608
Mailing Address - Country:US
Mailing Address - Phone:440-376-0994
Mailing Address - Fax:
Practice Address - Street 1:990 S PROSPECT ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-6283
Practice Address - Country:US
Practice Address - Phone:740-387-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT018805225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist