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General NPI Number Information
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NPI Number | 1730465246
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Entity Type | Individual
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Provider Name | MICHELLE NICOLE CHAMBERLAIN MS, LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 10/28/2011
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 669 E MAIN ST
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City | NEW HOLLAND
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State | PA
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Zip | 17557-1409
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Country | US
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Telephone | 717-354-1139
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Fax |
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Provider Business Mailing Address
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Address Line | 669 EAST MAIN STREET
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City | NEW HOLLANND
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State | PA
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Zip | 17557-0609
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Country | US
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Telephone | 717-368-0823
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AL3125
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | RT005213
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License Number State | PA
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