Provider Demographics
NPI:1336966696
Name:TRINKO, MICHAEL R
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:R
Last Name:TRINKO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1388 ROBB RD
Mailing Address - Street 2:
Mailing Address - City:CONNEAUT
Mailing Address - State:OH
Mailing Address - Zip Code:44030-1038
Mailing Address - Country:US
Mailing Address - Phone:440-645-6947
Mailing Address - Fax:
Practice Address - Street 1:1388 ROBB RD
Practice Address - Street 2:
Practice Address - City:CONNEAUT
Practice Address - State:OH
Practice Address - Zip Code:44030-1038
Practice Address - Country:US
Practice Address - Phone:440-645-6947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRM913438172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver