Provider Demographics
NPI:1528798998
Name:CAMPBELL, BERNADETTE MARY
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:MARY
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 BATTLE ST
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NH
Mailing Address - Zip Code:03303-7317
Mailing Address - Country:US
Mailing Address - Phone:603-568-0936
Mailing Address - Fax:
Practice Address - Street 1:GRANITE LEDGES
Practice Address - Street 2:151 LANGLEY PARKWAY
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:603-224-0777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist