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General NPI Number Information
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NPI Number | 1992562185
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Entity Type | Individual
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Provider Name | TRINITY CONE PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 03/04/2024
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 202 S HARTFORD ST
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City | BRECKENRIDGE
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State | TX
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Zip | 76424-4713
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Country | US
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Telephone | 254-559-1864
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Fax |
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Provider Business Mailing Address
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Address Line | 8091 US HIGHWAY 180 E
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City | BRECKENRIDGE
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State | TX
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Zip | 76424-7804
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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 | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 1321314
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License Number State | TX
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