Provider Demographics
NPI:1174767909
Name:BISHOP, CAMERON (DAOM LAC)
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:
Last Name:BISHOP
Suffix:
Gender:M
Credentials:DAOM LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 NORTH FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460
Mailing Address - Country:US
Mailing Address - Phone:561-533-7475
Mailing Address - Fax:561-533-7439
Practice Address - Street 1:1505 NORTH FEDERAL HIGHWAY
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460
Practice Address - Country:US
Practice Address - Phone:561-533-7475
Practice Address - Fax:561-533-7439
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-23
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP762171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist