Individual
VINCENT GERARD CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 645-0553
Mailing address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 645-0553
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31001821A
IN
Other
Enumeration date
05/17/2007
Last updated
09/03/2021
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