Organization
CAMPBELL THERAPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANI DEVON CAMPBELL PT (CEO)
(731) 641-8111
Entity
Organization
Contact information
Practice address
109 COMMERCE ST, PARIS, TN 38242-4917
(731) 641-8111
(731) 641-8110
Mailing address
PO BOX 739, DOVER, TN 37058-0739
(731) 641-8111
(731) 641-8110
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
TN
225X00000X
Occupational Therapist
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12115
VA
TN
05
—
3729568
—
TN
01
—
P00103288
PALMETTO GBA RR MEDICARE
TN
Enumeration date
07/19/2006
Last updated
12/15/2008
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