Individual
DIANA GLOVER-CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CO, CPED, CFM
Contact information
Practice address
520 BROOKDALE DR, LOWER LEVEL, STATESVILLE, NC 28677-4108
(704) 872-1037
(704) 872-1987
Mailing address
520 BROOKDALE DR, LOWER LEVEL, STATESVILLE, NC 28677-4108
(704) 872-1037
(704) 872-1987
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
222Z00000X
Orthotist
C15207
MD
224900000X
Mastectomy Fitter
CFM02153
DE
224L00000X
Pedorthist
CPED0524
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7704084
—
NC
05
—
7795135
—
NC
05
—
7795136
—
NC
05
—
7795450
—
NC
Enumeration date
08/15/2007
Last updated
01/11/2013
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