Individual
MR. TREVOR GLENN GLEASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2291 MARKS RD, CLYMER, NY 14724-9742
(716) 499-9925
Mailing address
2291 MARKS RD, CLYMER, NY 14724-9742
(716) 499-9925
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2120638
TX
Other
Enumeration date
07/07/2016
Last updated
07/07/2016
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