Individual
VANESSA TREVATHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
124 W CRESCENT SQUARE DR, GRAHAM, NC 27253-4014
(336) 227-0730
(336) 227-0732
Mailing address
540 W ELM ST, GRAHAM, NC 27253-2158
(336) 227-0730
(336) 227-0732
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7704282
—
NC
Enumeration date
08/28/2014
Last updated
08/19/2021
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