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General NPI Number Information
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NPI Number | 1467925453
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Entity Type | Individual
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Provider Name | ANDRU WILTON TRENARY
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Gender | Male
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Dates
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Enumeration Date | 01/02/2019
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Last Update Date | 05/01/2019
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Provider Practice Location Address
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Address Line | 9910 COWARD MILL RD
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City | KNOXVILLE
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State | TN
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Zip | 37931-3101
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Country | US
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Telephone | 865-851-8104
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Fax |
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Provider Business Mailing Address
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Address Line | 15 HYSLIP FORD RD
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City | BUNKER HILL
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State | WV
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Zip | 25413-2965
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Country | US
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Telephone |
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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 | A5013
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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