Provider Demographics
NPI:1730369604
Name:CAMPBELL, MARCIA RAYLENE PRITCHETT (DC)
Entity type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:RAYLENE PRITCHETT
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1930
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-0033
Mailing Address - Country:US
Mailing Address - Phone:770-827-9695
Mailing Address - Fax:
Practice Address - Street 1:802 DACULA RD
Practice Address - Street 2:SUITE 202
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-3324
Practice Address - Country:US
Practice Address - Phone:770-827-9695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6054111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor