Provider Demographics
NPI:1184687360
Name:HOWERTON, RAY SCOTT (MS, ATC, LAT, CSCS,)
Entity Type:Individual
Prefix:MR
First Name:RAY
Middle Name:SCOTT
Last Name:HOWERTON
Suffix:
Gender:M
Credentials:MS, ATC, LAT, CSCS,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:849 PROVANCE
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92545
Mailing Address - Country:US
Mailing Address - Phone:951-652-4567
Mailing Address - Fax:
Practice Address - Street 1:17500 PERRIS BLVD
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92551-9547
Practice Address - Country:US
Practice Address - Phone:951-601-3028
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT 20562255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer