Provider Demographics
NPI:1801261193
Name:CAMERON, CHRISTOPHER (AT/ATC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:CAMERON
Suffix:
Gender:M
Credentials:AT/ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9703 FOXHOUND DR
Mailing Address - Street 2:APT. 2C
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-5575
Mailing Address - Country:US
Mailing Address - Phone:937-478-8887
Mailing Address - Fax:
Practice Address - Street 1:1675 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGBORO
Practice Address - State:OH
Practice Address - Zip Code:45066-1524
Practice Address - Country:US
Practice Address - Phone:937-748-3950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-11
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT. 002985390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program