Individual
GEOFFRE TRIMBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
4719 KAIBAB TRL, FORT WAYNE, IN 46808-3579
(260) 519-3183
Mailing address
4719 KAIBAB TRL, FORT WAYNE, IN 46808-3579
(260) 519-3183
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.003713
IL
224Z00000X
Occupational Therapy Assistant
32002271A
IN
Other
Enumeration date
01/03/2013
Last updated
01/03/2013
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