Lider, Camille

Lider, Camille is an individual health care provider with primary practice located at 3476 W 4600 S , West Haven UT 84401. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Lider, Camille can be contacted via phone (801) 689-0200.

Contact Information

Primary practice address
3476 W 4600 S West Haven UT 84401
Phone: (801) 689-0200
Fax: (801) 689-0201
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 10789141-2401 Utah

Profile Details

NPI number 1801142518
LBN Legal business name Lider, Camille
Credentials DPT
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2012
Last updated May 21st, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801142518 NPPES
Other 1801142518 NPI
Other 10789141-2401 NPI
Other 12756913 NPI
MEDICAID 3008026 NPI

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