Basic Information
Provider Information
NPI: 1760891006
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOWARD
FirstName: HUSAYN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: OTR/L, PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 711185
Address2:  
City: SALT LAKE CITY
State: UT
PostalCode: 841711185
CountryCode: US
TelephoneNumber: 8019423311
FaxNumber: 8019425955
Practice Location
Address1: 1952 E 7000 S
Address2:  
City: SALT LAKE CITY
State: UT
PostalCode: 841216877
CountryCode: US
TelephoneNumber: 8019423311
FaxNumber: 8019425955
Other Information
ProviderEnumerationDate: 08/12/2014
LastUpdateDate: 04/26/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X13231CAN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 
225100000X3287NVY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225X00000X15-0575NVN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 
225100000X43473CAN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X1258687TXN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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