Individual
TIFFANY CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
140 RIVER RIDGE RD, MADISON HEIGHTS, VA 24572-2344
(434) 941-2360
Mailing address
140 RIVER RIDGE RD, MADISON HEIGHTS, VA 24572-2344
(434) 941-2360
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B031000903
COMMONWEALTH OF VIRGINIA
VA
Enumeration date
08/21/2014
Last updated
08/21/2014
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