Individual
SUSAN DIANE TRIMBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
15822 CLAYTON RD, ELLISVILLE, MO 63011-2212
(636) 220-1681
Mailing address
1303 SPRING PARK DR, SAINT CHARLES, MO 63303-6491
(314) 606-2525
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
116757
MO
Other
Enumeration date
08/13/2021
Last updated
08/13/2021
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