Provider Demographics
NPI:1417179474
Name:HOWARD, LARRY ALAN (MA, ATC, LAT,)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:ALAN
Last Name:HOWARD
Suffix:
Gender:M
Credentials:MA, 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:WILMINGTON COLLEGE
Mailing Address - Street 2:1870 QUAKER WAY, BOX 1246
Mailing Address - City:WILMINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:45177
Mailing Address - Country:US
Mailing Address - Phone:937-382-6661
Mailing Address - Fax:
Practice Address - Street 1:WILMINGTON COLLEGE
Practice Address - Street 2:1870 QUAKER WAY, BOX 1246
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177
Practice Address - Country:US
Practice Address - Phone:937-382-6661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT-0000672255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer