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Individual

MR. BILLY RAY CAMPBELL III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPED, CFO

Contact information

Practice address
315 E BROADWAY STE 1400, LOUISVILLE, KY 40202-3700
(502) 629-8640
(502) 629-5527
Mailing address
3401 IMPERATOR LN UNIT 102, LOUISVILLE, KY 40245-7707
(502) 593-6119

Taxonomy

Speciality
Code
Description
License number
State
224L00000X
Pedorthist
CPED3595
KY
225000000X
Orthotic Fitter
Primary
CFO04010
KY

Other

Enumeration date
03/09/2017
Last updated
03/09/2017
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