Christopher Lee Davis

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Scottsburg, IN

NPI 1679936801 · NPPES record last updated Apr 4, 2016

Key facts

NPI
1679936801
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
160 E Jefferson St
Scottsburg, IN 47170-1943
Phone
(812) 595-4195
NPI assigned
Apr 4, 2016
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

160 E Jefferson St
Scottsburg, IN 47170-1943

Mailing address

160 E Jefferson St
Scottsburg, IN 47170-1943
Phone (812) 595-4195

Other providers in Scottsburg, IN

All providers in Scottsburg, IN · Student in an Organized Health Care Education/Training Program in Indiana

Sources for this page

Verify at the official NPI Registry.