Provider Demographics
NPI:1043709835
Name:CAMPOS-BARD, LMT, DEBORAH J (LMT)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:J
Last Name:CAMPOS-BARD, LMT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:J
Other - Last Name:CAMPOS-BARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:1925 OREGON PIKE APT L5
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-6455
Mailing Address - Country:US
Mailing Address - Phone:607-379-2722
Mailing Address - Fax:
Practice Address - Street 1:439 N. DUKE ST. 2ND FL.
Practice Address - Street 2:2
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602
Practice Address - Country:US
Practice Address - Phone:717-669-1030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG011684225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist