Provider Demographics
NPI:1386163152
Name:BODNAR, TREVOR (OTR/L)
Entity type:Individual
Prefix:
First Name:TREVOR
Middle Name:
Last Name:BODNAR
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 S VANCE ST APT 303
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-4977
Mailing Address - Country:US
Mailing Address - Phone:908-528-6544
Mailing Address - Fax:
Practice Address - Street 1:815 S VANCE ST APT 303
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-4977
Practice Address - Country:US
Practice Address - Phone:908-528-6544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist