Individual
CHRISTOPHER WILLIAM O'BRIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LAT, ATC
Contact information
Practice address
KING'S COLLEGE, 133 NORTH RIVER STREET, WILKES-BARRE, PA 18711
(570) 208-8404
Mailing address
627 MARY JO DR, JESSUP, PA 18434-1965
(570) 430-9225
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
001603-1
NY
2255A2300X
Athletic Trainer
Primary
RT001243A
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001603-1
OFFICE OF THE PROFESSIONS, THE UNIVERSITY OF THE STATE OF NY EDUCATION DEPT.
NY
01
—
RT001243A
BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS, PA DEPT. OF STATE
PA
Enumeration date
10/20/2006
Last updated
04/05/2019
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