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General NPI Number Information
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NPI Number | 1205626868
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Entity Type | Individual
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Provider Name | COLLIN HAUSCHILD
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Gender | Male
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 3450 MONONGAHELA BLVD
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City | MORGANTOWN
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State | WV
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Zip | 26505-3043
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Country | US
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Telephone | 304-288-3658
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Fax |
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Provider Business Mailing Address
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Address Line | 1227 VAN VOORHIS RD
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City | MORGANTOWN
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State | WV
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Zip | 26505-0305
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Country | US
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Telephone | 845-428-2805
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT001918
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License Number State | WV
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