Provider Demographics
NPI:1922534502
Name:HOUCK, KERRI (ATC)
Entity Type:Individual
Prefix:
First Name:KERRI
Middle Name:
Last Name:HOUCK
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:KERRI
Other - Middle Name:MARIE
Other - Last Name:ZAMORA FLORES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ATC
Mailing Address - Street 1:290 NE 40TH ST
Mailing Address - Street 2:APT 20
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-1373
Mailing Address - Country:US
Mailing Address - Phone:561-250-2410
Mailing Address - Fax:
Practice Address - Street 1:4691 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-3817
Practice Address - Country:US
Practice Address - Phone:954-434-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL28292255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer