Provider Demographics
NPI:1972897528
Name:CHAMBERS, GARY JAMES JR (ATP, RTS)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:JAMES
Last Name:CHAMBERS
Suffix:JR
Gender:M
Credentials:ATP, RTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 N 13TH ST
Mailing Address - Street 2:
Mailing Address - City:GROVER BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93433-2206
Mailing Address - Country:US
Mailing Address - Phone:805-270-5785
Mailing Address - Fax:413-294-3912
Practice Address - Street 1:255 N 13TH ST
Practice Address - Street 2:
Practice Address - City:GROVER BEACH
Practice Address - State:CA
Practice Address - Zip Code:93433-2206
Practice Address - Country:US
Practice Address - Phone:805-270-5785
Practice Address - Fax:413-294-3912
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies