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1730250861
JUSTIN DAVID WHITEHOUSE
PHOENIX, AZ
NPI
1730250861
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL 96002241)
Enumeration Date
2006-11-12
Last Update Date
2007-07-08
Business Address
-- JUSTIN DAVID WHITEHOUSE M.A., ATC
1802 N 64TH ST
PHOENIX, AZ 85008-3400
Phone number: 480-949-5951
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Mailing Address
-- JUSTIN DAVID WHITEHOUSE M.A., ATC
315 HOBBLE BUSH DR
LAKE ZURICH, IL 60047-2739
Phone number: 847-540-8770
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