| Doctor Name: | TREVOR E CARLSON |
| NPI Number: | 1982980082 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | PT38366 |
| Business Practice Address: | 1585 Heartwood Dr Ste H Mckinleyville, CA - 955193993 |
| Business Phone Number: | 7078391802 |
| Business Fax Number: | 7078393507 |
| Mailing Address: | 2306 Dean St, EUREKA |
| State: | CA |
| Postal Code: | 955013209 |
| Phone Number: | 7074438354 |
| Fax Number: | 7074438628 |
| NPI Enumeration Date: | 11/02/2011 |
| NPI Last Update Date: | 04/19/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | PT38366 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |