Mark Warren Huntington, ATC, PT
Individual provider Active NPI Athletic Trainer · North Manchester, IN
NPI 1063544179 · NPPES record last updated Feb 13, 2012
Key facts
- NPI
- 1063544179
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 36000081A (IN)
- Practice address
- 604 E College Ave
North Manchester, IN 46962-1276 - Phone
- (260) 982-5033
- Fax
- (260) 982-5032
- NPI assigned
- Mar 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1268 | IN | MD | Physical Therapist |
| 36000081A | IN | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1268 | IN | |
| Athletic Trainer | 2255A2300X | 36000081A | IN | Yes |
Addresses
Primary practice location
604 E College Ave
North Manchester, IN 46962-1276
Mailing address
903 State Road 114 E
North Manchester, IN 46962-9382
Phone (260) 982-7819
Other providers in North Manchester, IN
- Joel M Harman
- Suzanna Hicks
- Hill Chiropractic LLC
- Andrew Hill
- Hometown Hearing & Audiology, LLC
- Indiana Home Health Care Solutions, Inc
- Melissa Lee Jimenez
- Joel Harman D.C., LLC
- Patricia Lynn Jones
- Beth Lisa Kaskel
All providers in North Manchester, IN · Athletic Trainer in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.