Basic Information
| Provider Information | |||||||||
| NPI: | 1376804930 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAMPBELL | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 SAUNDERS ROAD | ||||||||
| Address2: | |||||||||
| City: | MCADAM | ||||||||
| State: | NEW BRUNSWICK | ||||||||
| PostalCode: | E6J1L6 | ||||||||
| CountryCode: | CA | ||||||||
| TelephoneNumber: | 5067841089 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4205 FRANKLIN AVE | ||||||||
| Address2: | CONCENTRA URGENT CARE | ||||||||
| City: | WACO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 767106904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2547722777 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2012 | ||||||||
| LastUpdateDate: | 05/30/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1216502 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.