Individual
TRACEY LYNN CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
2 MEDICAL PARK RD STE 107, COLUMBIA, SC 29203-6839
(803) 434-4480
(803) 434-3340
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1488
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DT1096
—
SC
Enumeration date
05/23/2016
Last updated
05/23/2023
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