Provider Demographics
NPI:1982065843
Name:CAMPBELL, MEGAN (MS, ATC, CES)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MS, ATC, CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47201 CALCUTTA SMITHFERRY RD
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-9004
Mailing Address - Country:US
Mailing Address - Phone:330-383-1933
Mailing Address - Fax:
Practice Address - Street 1:195 GOLDEN BEAR DR
Practice Address - Street 2:
Practice Address - City:NEW CUMBERLAND
Practice Address - State:WV
Practice Address - Zip Code:26047-1672
Practice Address - Country:US
Practice Address - Phone:330-383-1933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-18
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAT0013472255A2300X
OHAT.0042422255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer