Healthcare Provider Details

I. General information

NPI: 1861594194
Provider Name (Legal Business Name): CHRISTOPHER JAMES COMPTON MS, LAT, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 12/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S ODELL ST
BROWNSBURG IN
46112-1929
US

IV. Provider business mailing address

1703 QUINN CREEK DR
BROWNSBURG IN
46112-2192
US

V. Phone/Fax

Practice location:
  • Phone: 317-852-2258
  • Fax:
Mailing address:
  • Phone: 317-852-2258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: