Chandra M. Dyer, ATC
Individual provider Active NPI Athletic Trainer · Guthrie, OK
NPI 1306175385 · NPPES record last updated Dec 21, 2009
Key facts
- NPI
- 1306175385
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 569 (OK)
- Practice address
- 200 S Academy Rd
Guthrie, OK 73044-8727 - Phone
- (405) 683-1550
- NPI assigned
- Dec 21, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 569 | OK | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 569 | OK | Yes |
Addresses
Primary practice location
200 S Academy Rd
Guthrie, OK 73044-8727
Mailing address
200 S Academy Rd
P.O. Box 1017
Guthrie, OK 73044-8727
Phone (405) 380-3062
Other providers in Guthrie, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.