Doctor Name: | TRENT M EZZELL |
NPI Number: | 1508072885 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 9752 |
Business Practice Address: | 718 N Main St Unit # 18 Gunnison, CO - 812302412 |
Business Phone Number: | 9706413298 |
Business Fax Number: | 9706417369 |
Mailing Address: | 718 N Main St, Unit # 18 GUNNISON |
State: | CO |
Postal Code: | 812302412 |
Phone Number: | 9706413298 |
Fax Number: | 9706417369 |
NPI Enumeration Date: | 05/15/2007 |
NPI Last Update Date: | 10/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 9752 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
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 |