Provider Demographics
NPI:1780912840
Name:HAMLYN, CHRIS JAMES (EDD, LAT, ATC, CSCS)
Entity type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:JAMES
Last Name:HAMLYN
Suffix:
Gender:M
Credentials:EDD, LAT, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3502 RIVER BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46012-4636
Mailing Address - Country:US
Mailing Address - Phone:765-620-2584
Mailing Address - Fax:
Practice Address - Street 1:1100 E 5TH ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46012-3495
Practice Address - Country:US
Practice Address - Phone:765-641-3792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-01
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36001424A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer