Provider Demographics
NPI:1285227595
Name:HILLS, AUSTIN JAMES (ATC, LAT)
Entity Type:Individual
Prefix:MR
First Name:AUSTIN
Middle Name:JAMES
Last Name:HILLS
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2745 40TH ST S APT 309
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-7517
Mailing Address - Country:US
Mailing Address - Phone:320-287-2079
Mailing Address - Fax:
Practice Address - Street 1:649 17TH STREET S
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56563
Practice Address - Country:US
Practice Address - Phone:320-287-2079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN34032255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer