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NPI Code Detail

MEDICARE: MICHAEL HOUK ATC

MEDICARE: MICHAEL HOUK ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer

General Provider Information

NPI Number : 1881043438
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL HOUK ATC
Provider Business Mailing Address
First Line : 47551 TOMAHAWK DR
Second Line :
City : NEGLEY
State : OH
Zip : 44441-9724
Country : US
Telephone Number : 330-303-5056
Fax Number :
Provider Business Practice Location Address
First Line : 1 BUCCANEER PL
Second Line :
City : TAMPA
State : FL
Zip : 33607-5701
Country : US
Telephone Number : 330-303-5056
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2016
Last Update Date : 06/05/2016

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