Provider Demographics
NPI:1881632743
Name:CAMPION, SHANNON KATHLEEN (MPT)
Entity Type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:KATHLEEN
Last Name:CAMPION
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 N MARKET ST
Mailing Address - Street 2:APT 308
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3814
Mailing Address - Country:US
Mailing Address - Phone:570-470-2674
Mailing Address - Fax:
Practice Address - Street 1:2129 W OREGON AVE
Practice Address - Street 2:THIRD FLOOR SUITE
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-4131
Practice Address - Country:US
Practice Address - Phone:215-336-6630
Practice Address - Fax:215-336-3928
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRPT017080225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist