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NPI Code Detail

MEDICARE: TREVOR JOSEPH HALBACH

MEDICARE: TREVOR JOSEPH HALBACH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251X0800XOrthopedic Physical Therapist
2225100000XPhysical Therapist6502OK

General Provider Information

NPI Number : 1487506689
Entity Type Code : Individual
Provider Name (Legal Business Name) : TREVOR JOSEPH HALBACH
Provider Business Mailing Address
First Line : 214 E JUNEAU PL
Second Line :
City : BROKEN ARROW
State : OK
Zip : 74012-8248
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1809 E 13TH ST
Second Line :
City : TULSA
State : OK
Zip : 74104-4419
Country : US
Telephone Number : 918-579-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2026
Last Update Date : 02/10/2026

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Directions to “ TREVOR JOSEPH HALBACH ” Practice Location

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