Provider Demographics
NPI:1649690512
Name:HOULE, KACY (DPT)
Entity type:Individual
Prefix:
First Name:KACY
Middle Name:
Last Name:HOULE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1085 S LINDEN RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3421
Mailing Address - Country:US
Mailing Address - Phone:810-262-2000
Mailing Address - Fax:810-230-3366
Practice Address - Street 1:1085 S LINDEN RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3421
Practice Address - Country:US
Practice Address - Phone:810-262-2000
Practice Address - Fax:810-230-3366
Is Sole Proprietor?:No
Enumeration Date:2014-04-18
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501016681225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist