Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NR0400X | Rehabilitation Chiropractor | CHIR007533 | GA |
Y | 111NR0400X | Rehabilitation Chiropractor | DC34488 | CA |
NPI | 1265636336 |
---|---|
Provider Name | Dr. Christopher Joseph Campagna |
First Address | Fortuna, CA 95540-3034 |
Second Address | Fortuna, CA 95540-3034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 09/09/2021 |