Doctor Name: | TRENDA DEAVER |
NPI Number: | 1316140031 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 1102915 |
Business Practice Address: | 141 Market Pl Suite 203 Fairview Heights, IL - 622082034 |
Business Phone Number: | 6183984118 |
Business Fax Number: | 8478819640 |
Mailing Address: | 141 Market Pl, Suite 203 FAIRVIEW HEIGHTS |
State: | IL |
Postal Code: | 622082034 |
Phone Number: | 6183984118 |
Fax Number: | 8478819640 |
NPI Enumeration Date: | 06/08/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 1102915 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
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 |