Provider Demographics
NPI:1619082500
Name:HOWE, LARRY JOHN (MS ATC)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:JOHN
Last Name:HOWE
Suffix:
Gender:M
Credentials:MS ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3731 SUNSET HWY N
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802
Mailing Address - Country:US
Mailing Address - Phone:509-630-9808
Mailing Address - Fax:509-886-3565
Practice Address - Street 1:3731 SUNSET HWY N
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802
Practice Address - Country:US
Practice Address - Phone:509-630-9808
Practice Address - Fax:509-886-3565
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1003882255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
100388OtherNATIONAL ATHLETIC TRAINER