Individual
JUSTIN DAVID WHITEHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., ATC
Contact information
Practice address
1802 N 64TH ST, PHOENIX, AZ 85008-3400
(480) 949-5951
Mailing address
315 HOBBLE BUSH DR, LAKE ZURICH, IL 60047-2739
(847) 540-8770
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
96002241
IL
Other
Enumeration date
11/12/2006
Last updated
07/08/2007
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