Provider Demographics
NPI:1457942997
Name:CAMPBELL, AMANDA WALKER (SAS)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:WALKER
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:SAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 S COIT ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-4422
Mailing Address - Country:US
Mailing Address - Phone:843-665-9349
Mailing Address - Fax:843-669-6122
Practice Address - Street 1:238 S COIT ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4422
Practice Address - Country:US
Practice Address - Phone:843-665-9349
Practice Address - Fax:843-669-6122
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist