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Individual

MRS. SHIRLEY A CAMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
11841 BENT BRANCH RD, PIKEVILLE, KY 41501-4731
(606) 631-9572
Mailing address
11841 BENT BRANCH RD, PIKEVILLE, KY 41501-4731
(606) 631-9572

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
7100034930
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100034930
KY
Enumeration date
06/13/2008
Last updated
06/13/2008
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