Healthcare Provider Details

I. General information

NPI: 1871159384
Provider Name (Legal Business Name): DARREN LEE HOWARD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2019
Last Update Date: 05/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 E CHURCH ST # 337
NEW VIENNA OH
45159-5016
US

IV. Provider business mailing address

99 E CHURCH ST # 337
NEW VIENNA OH
45159-5016
US

V. Phone/Fax

Practice location:
  • Phone: 937-205-7639
  • Fax:
Mailing address:
  • Phone: 937-205-7639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: