Provider Demographics
NPI:1053699686
Name:KAMPEN, COLE MCVEY (PT)
Entity type:Individual
Prefix:
First Name:COLE
Middle Name:MCVEY
Last Name:KAMPEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:COLE
Other - Last Name:MCVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2450 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454-1450
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1591 YANCEYVILLE ST STE 400
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-6945
Practice Address - Country:US
Practice Address - Phone:336-274-7480
Practice Address - Fax:336-274-8903
Is Sole Proprietor?:No
Enumeration Date:2011-08-01
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8808225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist