Individual
MARIVIC E CAGAMPAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1500 OGLETHORPE AVE, ATHENS, GA 30606-2179
(706) 389-2273
Mailing address
PO BOX 6588, ST MARYS HOME HEALTH CARE, ATHENS, GA 30604-9828
(706) 389-2273
(706) 208-8883
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
002234
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00839352A
—
GA
Enumeration date
07/20/2006
Last updated
07/08/2007
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