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General NPI Number Information
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NPI Number | 1346874286
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Entity Type | Individual
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Provider Name | MR. MASON ALAN HUTTO
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Gender | Male
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Dates
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Enumeration Date | 03/01/2020
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Last Update Date | 03/01/2020
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Provider Practice Location Address
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Address Line | 915 E MARKET AVE
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City | SEARCY
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State | AR
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Zip | 72149-5615
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Country | US
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Telephone | 901-579-9192
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Fax |
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Provider Business Mailing Address
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Address Line | 2550 CURRYWOOD CV
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City | GERMANTOWN
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State | TN
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Zip | 38138-5713
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Country | US
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Telephone | 901-579-9192
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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 |
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License Number State | AR
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