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NPI Code Detail

MEDICARE: SEAN M TRAIT DPT

MEDICARE: SEAN M TRAIT DPT
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
1225100000XPhysical TherapistPT60762605WA
2225100000XPhysical Therapist

General Provider Information

NPI Number : 1992229017
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN M TRAIT DPT
Provider Business Mailing Address
First Line : 1650 LYNDON FARM CT STE 300
Second Line :
City : LOUISVILLE
State : KY
Zip : 40223-5005
Country : US
Telephone Number : 502-882-9379
Fax Number : 502-587-5728
Provider Business Practice Location Address
First Line : 110 MAIN ST
Second Line :
City : OXFORD
State : NC
Zip : 27565-3319
Country : US
Telephone Number : 919-853-7183
Fax Number : 919-853-7184
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2017
Last Update Date : 01/09/2024

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