Individual
DARYL HAUSAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LAT
Contact information
Practice address
4501 SUNFLOWER DR, KILLEEN, TX 76542-4608
(254) 291-6692
Mailing address
4501 SUNFLOWER DR, KILLEEN, TX 76542-4608
(254) 291-6692
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1737
TX
Other
Enumeration date
06/18/2012
Last updated
06/18/2012
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