Individual
CHRIS TRUJILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A-345
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3002080327
—
NM
Enumeration date
03/19/2020
Last updated
03/19/2020
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