Provider Demographics
NPI:1790055135
Name:POWERS, WILLIAM SCOTT (ATC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:SCOTT
Last Name:POWERS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 WILLOW DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:VA
Mailing Address - Zip Code:22821-9502
Mailing Address - Country:US
Mailing Address - Phone:540-810-5411
Mailing Address - Fax:540-515-3763
Practice Address - Street 1:124 WILLOW DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:VA
Practice Address - Zip Code:22821-9502
Practice Address - Country:US
Practice Address - Phone:540-810-5411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260003172255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer