Individual
TREVOR DANIEL VAN HAUTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(760) 271-0167
Mailing address
874 NEEDMORE RD APT E5, CLARKSVILLE, TN 37040-2335
(760) 271-0167
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/30/2017
Last updated
09/13/2023
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