Provider Demographics
NPI:1114270469
Name:MARKHAM, CLAIRE (MS, ATC)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:MARKHAM
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 EASTON POINT WAY
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-1889
Mailing Address - Country:US
Mailing Address - Phone:503-490-6022
Mailing Address - Fax:
Practice Address - Street 1:103 EASTON POINT WAY
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-1889
Practice Address - Country:US
Practice Address - Phone:503-490-6022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36001520A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer