Provider Demographics
NPI:1356316764
Name:MAACK, WILLIAM H III (ATC, CSCS)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:H
Last Name:MAACK
Suffix:III
Gender:M
Credentials:ATC, CSCS
Other - Prefix:
Other - First Name:BJ
Other - Middle Name:
Other - Last Name:MAACK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1 CYPRESS CV
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-4466
Mailing Address - Country:US
Mailing Address - Phone:501-351-7979
Mailing Address - Fax:
Practice Address - Street 1:1 CYPRESS CV
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223
Practice Address - Country:US
Practice Address - Phone:501-351-7979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAT1032255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer