| Doctor Name: | MR. BRIAN RICHARD TRUDEAU |
| NPI Number: | 1235207937 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.T. |
| License Number: | 669 |
| Business Practice Address: | 211 E Logan St Suite 101 Caldwell, ID - 836054882 |
| Business Phone Number: | 2084549839 |
| Business Fax Number: | |
| Mailing Address: | 11581 W Creekrapids Dr, STAR |
| State: | ID |
| Postal Code: | 836695729 |
| Phone Number: | 2082867292 |
| Fax Number: | |
| NPI Enumeration Date: | 12/01/2006 |
| NPI Last Update Date: | 12/05/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 669 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |