MEDICARE: LOUISE TRENT PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2957	NV

General Provider Information

NPI Number	:	1780074781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUISE TRENT PT

Provider Business Mailing Address
First Line	:	790 REMINGTON BLVD
Second Line	:
City	:	BOLINGBROOK
State	:	IL
Zip	:	60440-4909
Country	:	US
Telephone Number	:	630-296-2223
Fax Number	:	630-759-9510

Provider Business Practice Location Address
First Line	:	8945 W POST RD STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-2430
Country	:	US
Telephone Number	:	702-251-7147
Fax Number	:	702-251-7151

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2015
Last Update Date	:	09/10/2015

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Directions to “ LOUISE TRENT PT” Practice Location

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