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General NPI Number Information
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NPI Number | 1023606324
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Entity Type | Individual
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Provider Name | TREVOR NATHANIEL ZAJAC LPTA
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Gender | Male
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Dates
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Enumeration Date | 01/04/2021
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Last Update Date | 01/04/2021
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Provider Practice Location Address
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Address Line | 55 PINEY MOUNTAIN DR
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City | ASHEVILLE
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State | NC
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Zip | 28805-1297
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Country | US
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Telephone | 828-348-8804
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Fax |
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Provider Business Mailing Address
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Address Line | 134 LUCAS ST
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City | CONNELLY SPRINGS
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State | NC
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Zip | 28612-7931
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Country | US
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Telephone | 828-493-3155
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | A6721
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License Number State | NC
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