Nicole Campbell, | |
25 West St, Tunkhannock, PA 18657-1405 | |
(579) 996-6200 | |
Not Available |
Full Name | Nicole Campbell |
---|---|
Gender | Female |
Speciality | Speech-language Pathologist |
Location | 25 West St, Tunkhannock, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013580604 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | PSL001590 (Pennsylvania) | Primary |
Provider Name | Pivot Physical Therapy Of Pennsylvania Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1881132488 PECOS PAC ID: 4981971843 Enrollment ID: O20170515000834 |
Mailing Address | Practice Location Address |
---|---|
Nicole Campbell, 108 Old Orchard Rd, Clarks Summit, PA 18411-1120 Ph: (570) 903-1985 | Nicole Campbell, 25 West St, Tunkhannock, PA 18657-1405 Ph: (579) 996-6200 |
Chantal Whiteduck, M.S., CF-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 25 West St, Tunkhannock, PA 18657 Phone: 570-996-6200 | |
Amanda M Tohme, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 25 West St, Tunkhannock, PA 18657 Phone: 570-996-6200 Fax: 570-996-6201 | |
Caley Reeves, SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 25 West St, Tunkhannock, PA 18657 Phone: 570-996-6200 Fax: 570-996-6201 |