Provider Demographics
NPI:1649909979
Name:CAMOU HOLDINGS
Entity type:Organization
Organization Name:CAMOU HOLDINGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMOU
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:623-337-2125
Mailing Address - Street 1:13128 N 94TH DRIVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4253
Mailing Address - Country:US
Mailing Address - Phone:623-337-2125
Mailing Address - Fax:
Practice Address - Street 1:13128 N 94TH DRIVE
Practice Address - Street 2:SUITE 207
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4253
Practice Address - Country:US
Practice Address - Phone:623-974-1797
Practice Address - Fax:623-974-1796
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VALLEY REHABILITATION, LTD.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy