Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 21628 | MA |
N | 2251N0400X | Physical Therapist - Neurology | 2020023533 | MO |
NPI | 1538548797 |
---|---|
Provider Name | Nidhi Trehan |
First Address | Ballwin, MO 63011-5107 |
Second Address | Woburn, MA 01801-7452 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2015 |
Last Update Date | 27/08/2020 |