Provider Demographics
NPI:1932445731
Name:CAMP, MARLEE DAWN
Entity Type:Individual
Prefix:DR
First Name:MARLEE
Middle Name:DAWN
Last Name:CAMP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARLEE
Other - Middle Name:DAWN
Other - Last Name:KEVECH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:125 MAIN ST W
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:MS
Mailing Address - Zip Code:38652-3324
Mailing Address - Country:US
Mailing Address - Phone:662-539-7079
Mailing Address - Fax:662-539-7119
Practice Address - Street 1:125 MAIN ST W
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:MS
Practice Address - Zip Code:38652-3324
Practice Address - Country:US
Practice Address - Phone:662-539-7079
Practice Address - Fax:662-539-7119
Is Sole Proprietor?:No
Enumeration Date:2012-12-25
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2632111N00000X
MS1252111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor