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Individual
TRAE ANTHONY MINGUS
Active
Individual
TRAE ANTHONY MINGUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
10373
SC
225100000X
Physical Therapist
Primary
P19546
NC
2251X0800X
Orthopedic Physical Therapist
Primary
P19646
NC
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
05/20/2016
Last updated
08/04/2026
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