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General NPI Number Information
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NPI Number | 1922544253
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Entity Type | Individual
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Provider Name | WILLIAM HOUCK
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Gender | Male
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Dates
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Enumeration Date | 01/10/2017
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Last Update Date | 06/12/2018
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Provider Practice Location Address
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Address Line | 925 ONE LANDON LOOP
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City | CONWAY
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State | SC
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Zip | 29526
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Country | US
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Telephone | 312-622-2677
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Fax |
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Provider Business Mailing Address
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Address Line | 1834 RIDGE AVE UNIT 138
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City | EVANSTON
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State | IL
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Zip | 60201-5902
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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 |
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License Number State |
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