Ian Campbell, DPT

Individual provider Active NPI Pediatric Physical Therapist · North Charleston, SC

NPI 1154875995 · NPPES record last updated Aug 10, 2016

Key facts

NPI
1154875995
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Physical Therapist 2251P0200X
License
8291 (SC)
Practice address
9225 University Blvd
Ste E2C
North Charleston, SC 29406-9149
Phone
(843) 569-4546
Fax
(843) 569-4535
NPI assigned
Aug 10, 2016
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
8291SCMDCounselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 8291 SC Yes

Addresses

Primary practice location

9225 University Blvd
Ste E2C
North Charleston, SC 29406-9149

Mailing address

9225 University Blvd
Ste E2C
North Charleston, SC 29406-9149
Phone (843) 569-4546

Other providers in North Charleston, SC

All providers in North Charleston, SC · Pediatric Physical Therapist in South Carolina

Sources for this page

Verify at the official NPI Registry.