Provider Demographics
NPI:1932334349
Name:CAMERON, CAROLINE M (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:M
Last Name:CAMERON
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6530 SCHROEDER RD APT 206
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-2489
Mailing Address - Country:US
Mailing Address - Phone:608-204-9976
Mailing Address - Fax:
Practice Address - Street 1:6530 SCHROEDER RD APT 206
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-2489
Practice Address - Country:US
Practice Address - Phone:608-204-9976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1125 024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist