Provider Demographics
NPI:1386171619
Name:TREXLER, TATUM
Entity type:Individual
Prefix:
First Name:TATUM
Middle Name:
Last Name:TREXLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:EMMAUS
Mailing Address - State:PA
Mailing Address - Zip Code:18049-2135
Mailing Address - Country:US
Mailing Address - Phone:610-739-7506
Mailing Address - Fax:
Practice Address - Street 1:800 HAUSMAN RD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9393
Practice Address - Country:US
Practice Address - Phone:610-391-8218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant