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Individual
TRENT A GERIG
Active
Individual
TRENT A GERIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P. T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070012235
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039040215
BCBS PROVIDER NUMER
IL
01
—
11581797
CAQH PROVIDER ID
IL
01
—
P00065046
RAILROAD MEDICARE PIN
—
Enumeration date
01/15/2007
Last updated
07/20/2011
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