Provider Demographics
NPI:1285102624
Name:CAMP, PATRICIA MARY (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARY
Last Name:CAMP
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8349 PLACER RD
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-9505
Mailing Address - Country:US
Mailing Address - Phone:530-262-7564
Mailing Address - Fax:
Practice Address - Street 1:8349 PLACER RD
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-9505
Practice Address - Country:US
Practice Address - Phone:530-262-7564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-04
Last Update Date:2018-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT13685261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy