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General NPI Number Information
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NPI Number | 1407373269
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Entity Type | Individual
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Provider Name | ZACHARY HOWARD MS, LAT, ATC
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Gender | Male
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Dates
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Enumeration Date | 08/23/2017
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Last Update Date | 08/23/2017
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Provider Practice Location Address
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Address Line | 101 CUMMINGS DR
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City | BRUNSWICK
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State | MD
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Zip | 21716-1857
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Country | US
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Telephone | 240-236-8600
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Fax |
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Provider Business Mailing Address
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Address Line | 141 THOMAS JOHNSON DR
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City | FREDERICK
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State | MD
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Zip | 21702-4502
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Country | US
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Telephone |
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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 | A00670
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License Number State | MD
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