Joseph Champagne, PT

Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Mount Shasta, CA

NPI 1982932513 · NPPES record last updated Nov 19, 2009

Key facts

NPI
1982932513
Entity type
Individual (NPI type 1)
Primary specialty
Physical Medicine & Rehabilitation Physician 208100000X
License
19766 (CA)
Practice address
633 Lassen LN
Mount Shasta, CA 96067-9002
Phone
(530) 926-6010
Fax
(530) 926-6909
NPI assigned
Nov 19, 2009
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)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 19766 CA Yes

Addresses

Primary practice location

633 Lassen LN
Mount Shasta, CA 96067-9002

Mailing address

633 Lassen LN
Mount Shasta, CA 96067-9002
Phone (530) 926-6010

Other providers in Mount Shasta, CA

All providers in Mount Shasta, CA · Physical Medicine & Rehabilitation Physician in California

Sources for this page

Verify at the official NPI Registry.