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Individual
TREVOR WADE
Active
Individual
TREVOR WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305214855
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2305214855
BOARD OF PHYSICAL THERAPY
VA
Enumeration date
02/10/2022
Last updated
02/10/2022
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