Provider Demographics
NPI:1720347594
Name:MCKAMEY, JOHN JOSEPH (MMP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:JOSEPH
Last Name:MCKAMEY
Suffix:
Gender:M
Credentials:MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 OFFICE PARK CIR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2654
Mailing Address - Country:US
Mailing Address - Phone:205-388-4272
Mailing Address - Fax:
Practice Address - Street 1:9 OFFICE PARK CIR
Practice Address - Street 2:SUITE 110
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-2654
Practice Address - Country:US
Practice Address - Phone:205-388-4272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-14
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3479225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist