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General NPI Number Information
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NPI Number | 1568571131
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Entity Type | Individual
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Provider Name | TIMOTHY R TRAHANT LAC., PT, MSTCM
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Gender | Male
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 11/16/2022
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Provider Practice Location Address
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Address Line | 25 WATER ST
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City | GUILFORD
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State | CT
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Zip | 06437-2868
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Country | US
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Telephone | 860-552-8530
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Fax |
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Provider Business Mailing Address
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Address Line | 4 TWIN OAKS LN
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City | CLINTON
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State | CT
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Zip | 06413-1870
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Country | US
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Telephone | 860-669-9066
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 262
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 7329
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License Number State | CT
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