Individual
SANDRA SUE CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTAL
Contact information
Practice address
1 SUTPHIN DR, MARMET, WV 25315-1977
(304) 949-1580
Mailing address
PO BOX 224, ANSTED, WV 25812-0224
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C1617
WV
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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