Provider Demographics
NPI:1194333641
Name:DEVLIN, CHRISTOPHER JACOB (ATC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JACOB
Last Name:DEVLIN
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 1:8332 SEATTLE AVE APT 10112
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43240-1564
Mailing Address - Country:US
Mailing Address - Phone:517-599-3778
Mailing Address - Fax:
Practice Address - Street 1:8332 SEATTLE AVE APT 10112
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43240-1564
Practice Address - Country:US
Practice Address - Phone:517-599-3778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0061882083S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083S0010XAllopathic & Osteopathic PhysiciansPreventive MedicineSports Medicine