Healthcare Provider Details

I. General information

NPI: 1437877784
Provider Name (Legal Business Name): ERIN TAYLOR TRUMBACH DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2022
Last Update Date: 02/01/2023
Certification Date: 02/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2455 N NOBILE ST
PAULINA LA
70763-2528
US

IV. Provider business mailing address

3017 CYPRESS VIEW LN
BATON ROUGE LA
70810-0445
US

V. Phone/Fax

Practice location:
  • Phone: 504-343-1292
  • Fax:
Mailing address:
  • Phone: 985-201-4012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number11250
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number11250
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: