Provider Demographics
NPI:1710426317
Name:DOUTHIT, CHRISTOPHER RAY (MA, ATC, LAT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:RAY
Last Name:DOUTHIT
Suffix:
Gender:M
Credentials:MA, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CHERRYVALE
Mailing Address - State:KS
Mailing Address - Zip Code:67335-1403
Mailing Address - Country:US
Mailing Address - Phone:620-330-7207
Mailing Address - Fax:
Practice Address - Street 1:330 E 2ND ST
Practice Address - Street 2:
Practice Address - City:CHERRYVALE
Practice Address - State:KS
Practice Address - Zip Code:67335-1403
Practice Address - Country:US
Practice Address - Phone:620-330-7207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24-009322255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer