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Individual

ANGUS FERGUSON CAMPBELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
25 PINE CONE DR, PALM COAST, FL 32164-8423
(800) 796-0923
Mailing address
118 BONITA RD, ST AUGUSTINE, FL 32086-5706
(904) 315-9548

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA001935
FL

Other

Enumeration date
05/02/2011
Last updated
05/02/2011
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