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General NPI Number Information
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NPI Number | 1063329381
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Entity Type | Individual
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Provider Name | TREVOR MICHAEL JARSOMBECK DPT
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Gender | Male
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Dates
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Enumeration Date | 08/24/2026
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Last Update Date | 08/25/2026
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Provider Practice Location Address
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Address Line | 22454 US HIGHWAY 72 STE 300
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City | ATHENS
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State | AL
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Zip | 35613-2678
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Country | US
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Telephone | 256-233-2332
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Fax |
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Provider Business Mailing Address
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Address Line | 927 FRANKLIN ST SE
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City | HUNTSVILLE
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State | AL
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Zip | 35801-4306
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Country | US
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Telephone | 312-459-4699
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTH12804
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License Number State | AL
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