Provider Demographics
NPI:1336112135
Name:VERNON, CHRISTOPHER W (ATC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:W
Last Name:VERNON
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8902 N MERIDIAN ST
Mailing Address - Street 2:STE 101
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5382
Mailing Address - Country:US
Mailing Address - Phone:317-848-8048
Mailing Address - Fax:317-575-8807
Practice Address - Street 1:8902 N MERIDIAN ST
Practice Address - Street 2:STE 101
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5382
Practice Address - Country:US
Practice Address - Phone:317-848-8048
Practice Address - Fax:317-575-8807
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer