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Individual

JAKAYLA CAMPBELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
3096 SPRING HILL PKWY SE APT F, SMYRNA, GA 30080-4752
(843) 532-1531
Mailing address
3096 SPRING HILL PKWY SE APT F, SMYRNA, GA 30080-4752
(843) 532-1531

Taxonomy

Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
AT003670
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10131993
BITHDAY
Enumeration date
01/30/2020
Last updated
01/30/2020
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