Individual
LAKEITHA CAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1130 E SEMINARY DR # B, FORT WORTH, TX 76115-2830
(817) 922-9619
Mailing address
4521 MALLOW OAK DR, FORT WORTH, TX 76123-2754
(469) 531-3531
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
—
TX
Other
Enumeration date
02/29/2012
Last updated
03/09/2012
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