Provider Demographics
NPI:1336457167
Name:CHAMBERS, KARL (LMT / NMT)
Entity Type:Individual
Prefix:MR
First Name:KARL
Middle Name:
Last Name:CHAMBERS
Suffix:
Gender:M
Credentials:LMT / NMT
Other - Prefix:
Other - First Name:SPATOUCH
Other - Middle Name:
Other - Last Name:MOBILE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:PO BOX 56092
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30343-0092
Mailing Address - Country:US
Mailing Address - Phone:770-899-7511
Mailing Address - Fax:
Practice Address - Street 1:120 RALPH MCGILL BLVD NE
Practice Address - Street 2:#608
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-3347
Practice Address - Country:US
Practice Address - Phone:770-899-7511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT002968172M00000X, 174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist
No174H00000XOther Service ProvidersHealth Educator