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Individual

CARRIE DENISE CAMPBELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1031 BLACKWOLF RUN RD, DAVENPORT, FL 33896-7951
(863) 226-8553
Mailing address
PO BOX 1752, WINTER HAVEN, FL 33882-1752
(863) 226-8553

Taxonomy

Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
C514-104-76-582-0
FL

Other

Enumeration date
11/28/2020
Last updated
11/28/2020
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