Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | ||
N | 225100000X | Physical Therapist | PT-4550 | ID |
NPI | 1003266008 |
---|---|
Provider Name | Dr. David M Housewright |
First Address | Moline, IL 61265-8401 |
Second Address | Bettendorf, IA 52722-7565 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2016 |
Last Update Date | 18/06/2021 |