Provider Demographics
NPI:1346075314
Name:CAMPBELL, MITCHELL (DC)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 W 26TH ST STE 4
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-2470
Mailing Address - Country:US
Mailing Address - Phone:814-392-0453
Mailing Address - Fax:
Practice Address - Street 1:3330 W 26TH ST STE 4
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-2470
Practice Address - Country:US
Practice Address - Phone:814-392-0453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-07
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011965111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor