Provider Demographics
NPI:1548483357
Name:CAMPBELL, DIANE RUTHE (PT,DPT)
Entity type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:RUTHE
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2756 HARVEY AVE
Mailing Address - Street 2:
Mailing Address - City:LOWER BURRELL
Mailing Address - State:PA
Mailing Address - Zip Code:15068-3342
Mailing Address - Country:US
Mailing Address - Phone:724-212-3998
Mailing Address - Fax:
Practice Address - Street 1:2904 SEMINARY DR
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-3700
Practice Address - Country:US
Practice Address - Phone:724-832-8272
Practice Address - Fax:724-837-8278
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016165225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist