Basic Information
| Provider Information | |||||||||
| NPI: | 1770622250 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAMPBELL | ||||||||
| FirstName: | KATE | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20 RITA RD | ||||||||
| Address2: | |||||||||
| City: | RIDGEFIELD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068772238 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2034311493 | ||||||||
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| Practice Location | |||||||||
| Address1: | 96 ROUTE 37 | ||||||||
| Address2: | |||||||||
| City: | NEW FAIRFIELD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2033120211 | ||||||||
| FaxNumber: | 2033120201 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2007 | ||||||||
| LastUpdateDate: | 04/11/2014 | ||||||||
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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 | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.