Individual
TRACY HOUSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
500 COLE DR, PRAIRIE GROVE, AR 72753-2509
(479) 846-4212
Mailing address
13641 LOREN LN, FAYETTEVILLE, AR 72704-8413
(479) 422-0218
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
110102278
AR
Other
Enumeration date
04/24/2015
Last updated
04/24/2015
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