Provider Demographics
NPI:1760476261
Name:HULSEY, WILLIAM RONALD (ATC, LAT)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:RONALD
Last Name:HULSEY
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79015-1738
Mailing Address - Country:US
Mailing Address - Phone:806-655-4112
Mailing Address - Fax:806-353-6151
Practice Address - Street 1:6022 W 48TH AVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-7504
Practice Address - Country:US
Practice Address - Phone:806-355-5244
Practice Address - Fax:806-353-6151
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT18212255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer