Provider Demographics
NPI:1538599162
Name:KING, CHRIS (ATC)
Entity type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:
Last Name:KING
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9475 AMBROSE LN
Mailing Address - Street 2:
Mailing Address - City:KIMBERLY
Mailing Address - State:AL
Mailing Address - Zip Code:35091-2020
Mailing Address - Country:US
Mailing Address - Phone:205-379-4850
Mailing Address - Fax:205-379-4895
Practice Address - Street 1:1920 BLUE DEVIL DR
Practice Address - Street 2:
Practice Address - City:KIMBERLY
Practice Address - State:AL
Practice Address - Zip Code:35091-3174
Practice Address - Country:US
Practice Address - Phone:205-379-4850
Practice Address - Fax:205-379-4895
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0542255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer