Individual provider · NPI-1

Christopher Camburn

Specialist/Technologist, Athletic Trainer · Springfield, IL

NPI number1619356011
StatusActive
Last updated in NPPESDec 19, 2022

Details

NPI
1619356011
Entity type
Individual (NPI-1)
Name
Christopher Camburn
Sex
Male
Sole proprietor
Yes
Enumeration date
May 19, 2015
Certification date
Dec 18, 2022
Last updated
Dec 19, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic Trainer2601000631MIYes

Practice location

1 University Plz
Springfield, IL 62703-5497

Phone 989-780-4139

Mailing address

808 Chestnut Ct
Chatham, IL 62629-1495

Phone 989-780-4139

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