Provider Demographics
NPI:1770003907
Name:CHAMBERS, KELBY (MS, ATC, LAT)
Entity Type:Individual
Prefix:
First Name:KELBY
Middle Name:
Last Name:CHAMBERS
Suffix:
Gender:M
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5210 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72904-7362
Mailing Address - Country:US
Mailing Address - Phone:479-788-7686
Mailing Address - Fax:479-424-6686
Practice Address - Street 1:5210 GRAND AVE
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72904-7362
Practice Address - Country:US
Practice Address - Phone:479-788-7686
Practice Address - Fax:479-424-6686
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer