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Individual
TRENTON MADDOX
Active
Individual
TRENTON MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT017347
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16265863
CAQH NUMBER
—
Enumeration date
07/29/2024
Last updated
06/03/2025
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