Provider Demographics
NPI:1184809899
Name:CAMPBELL, JOSEPH EDWARD (OTR/L)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:EDWARD
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:553 N HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-1205
Mailing Address - Country:US
Mailing Address - Phone:215-886-7674
Mailing Address - Fax:
Practice Address - Street 1:553 N HILLS AVE
Practice Address - Street 2:
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-1205
Practice Address - Country:US
Practice Address - Phone:215-886-7674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC004092L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist