Provider Demographics
NPI:1700097573
Name:SVUBA, CAMELLIA NATAY (DC)
Entity Type:Individual
Prefix:DR
First Name:CAMELLIA
Middle Name:NATAY
Last Name:SVUBA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 3 BOX 3244
Mailing Address - Street 2:
Mailing Address - City:THAYER
Mailing Address - State:MO
Mailing Address - Zip Code:65791-9302
Mailing Address - Country:US
Mailing Address - Phone:417-264-2633
Mailing Address - Fax:
Practice Address - Street 1:38 COURT SQ
Practice Address - Street 2:
Practice Address - City:WEST PLAINS
Practice Address - State:MO
Practice Address - Zip Code:65775-3445
Practice Address - Country:US
Practice Address - Phone:417-256-4592
Practice Address - Fax:417-256-4596
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007013671111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor