Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT018638 | PA |
N | 2251S0007X | Physical Therapist - Sports | PT018638 | PA |
NPI | 1114143013 |
---|---|
Provider Name | Kevin Trexler |
First Address | Bethlehem, PA 18020-8062 |
Second Address | Bethlehem, PA 18020-8062 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2007 |
Last Update Date | 02/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2023535 | HIGHMARK PABS (01) | |
2849799000 | AMERIHEALTH IBC (01) | |
2849799000 | AMERIHEALTH/IBC (01) | PA |