Christopher Ray Douthit, M.A., ATC, LAT

Individual provider Active NPI Athletic Trainer · Cherryvale, KS

NPI 1710426317 · NPPES record last updated Feb 15, 2017

Key facts

NPI
1710426317
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
24-00932 (KS)
Practice address
330 E 2ND St
Cherryvale, KS 67335-1403
Phone
(620) 330-7207
NPI assigned
Feb 15, 2017
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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
24-00932KSMDAthletic Trainer

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 24-00932 KS Yes

Addresses

Primary practice location

330 E 2ND St
Cherryvale, KS 67335-1403

Mailing address

330 E 2ND St
Cherryvale, KS 67335-1403
Phone (620) 330-7207

Other providers in Cherryvale, KS

All providers in Cherryvale, KS · Athletic Trainer in Kansas

Sources for this page

Verify at the official NPI Registry.