Basic Information
| Provider Information | |||||||||
| NPI: | 1144888637 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHAMBERS | ||||||||
| FirstName: | CONNOR | ||||||||
| MiddleName: | W | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2592 13TH AVE | ||||||||
| Address2: | |||||||||
| City: | LINDSBORG | ||||||||
| State: | KS | ||||||||
| PostalCode: | 674565022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852120411 | ||||||||
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| Practice Location | |||||||||
| Address1: | 605 W LINCOLN ST | ||||||||
| Address2: | |||||||||
| City: | LINDSBORG | ||||||||
| State: | KS | ||||||||
| PostalCode: | 674562328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852273308 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2019 | ||||||||
| LastUpdateDate: | 05/30/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 11-06114 | KS | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.