NPI 1053966192 · live from the CMS NPI Registry
Trent Matthew Andre
Physical Therapist in Shreveport, LA. National Provider Identifier 1053966192, active.
NPI record
| NPI | 1053966192 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physical Therapist 225100000X |
| Practice location | 460 Ashley Ridge Blvd Ste 800, Shreveport, LA 71106 |
| Practice phone | 318-868-6172 |
| Enumerated | August 6, 2019 |
| Last updated | August 6, 2019 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physical Therapist primary | 225100000X | 10255 (LA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.