Provider Demographics
NPI:1841700176
Name:CAMPER PHYSICAL THERAPY
Entity type:Organization
Organization Name:CAMPER PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TABITHA
Authorized Official - Middle Name:BRASHER
Authorized Official - Last Name:CAMPER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:731-549-3155
Mailing Address - Street 1:1670 DUNBAR RD
Mailing Address - Street 2:
Mailing Address - City:DECATURVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38329-4222
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:494 TENNESSEE AVE S
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:TN
Practice Address - Zip Code:38363-4615
Practice Address - Country:US
Practice Address - Phone:731-257-1555
Practice Address - Fax:844-892-9378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-29
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation