Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | A05901 | IA |
NPI | 1538109749 |
---|---|
Provider Name | Dr. Ann Marie Campagna |
First Address | Riverdale, IA 52722-6320 |
Second Address | Clarence, IA 52216-7703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 04/01/2018 |