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General NPI Number Information
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NPI Number | 1992512412
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Entity Type | Individual
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Provider Name | JOHN TRENT PTA
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Gender | Male
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Dates
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Enumeration Date | 12/17/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 1952 E FORT UNION BLVD
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City | COTTONWOOD HEIGHTS
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State | UT
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Zip | 84121-6877
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Country | US
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Telephone | 801-942-3311
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Fax |
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Provider Business Mailing Address
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Address Line | 652 S 2500 W
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City | LEHI
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State | UT
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Zip | 84043-5848
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Country | US
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Telephone | 801-403-7539
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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 |
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License Number State |
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