Provider Demographics
NPI:1790822757
Name:ROBERT CAMPBELL DC PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ROBERT CAMPBELL DC PROFESSIONAL CORPORATION
Other - Org Name:DUNNS CORNERS CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC DACNB
Authorized Official - Phone:401-322-8822
Mailing Address - Street 1:259 POST ROAD
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891
Mailing Address - Country:US
Mailing Address - Phone:401-322-8822
Mailing Address - Fax:401-322-9191
Practice Address - Street 1:259 POST ROAD
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891
Practice Address - Country:US
Practice Address - Phone:401-322-8822
Practice Address - Fax:401-322-9191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00347111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI709003776Medicare UPIN
RI709003776Medicare PIN