Trevor Jon Vanasselt, PTA
Physical Therapy Assistant in New Hudson, MI. Individual provider (NPI-1).
NPI number1164095907
StatusActive
Last updated in NPPESJul 20, 2021
Details
- NPI
- 1164095907
- Entity type
- Individual (NPI-1)
- Name
- Trevor Jon Vanasselt
- Credential
- PTA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 20, 2021
- Certification date
- Jul 16, 2021
- Last updated
- Jul 20, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | – | – | Yes |
Practice location
29665 William K Smith DrNew Hudson, MI 48165-8580
Phone 517-420-8266
Mailing address
12881 Ten Mile RdSouth Lyon, MI 48178-9187
Phone 248-982-3426
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