Provider Demographics
NPI:1326482522
Name:HOUGH, RONALD JAMES (LAC)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:JAMES
Last Name:HOUGH
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4978 DAWN DR
Mailing Address - Street 2:
Mailing Address - City:GRAYLING
Mailing Address - State:MI
Mailing Address - Zip Code:49738-8646
Mailing Address - Country:US
Mailing Address - Phone:517-303-6317
Mailing Address - Fax:
Practice Address - Street 1:1125 E CLARK RD
Practice Address - Street 2:APT 5
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-3290
Practice Address - Country:US
Practice Address - Phone:517-303-6317
Practice Address - Fax:517-303-6317
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-18
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC 60337888171100000X
MIL458606171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist