Provider Demographics
NPI:1386360394
Name:TRENT, TERRY BRADLEY
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:BRADLEY
Last Name:TRENT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HOSPITAL ACCESS RD BC 1100
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912-0001
Mailing Address - Country:US
Mailing Address - Phone:839-255-7120
Mailing Address - Fax:704-519-2840
Practice Address - Street 1:HOSPITAL ACCESS RD BC 1100
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-0001
Practice Address - Country:US
Practice Address - Phone:839-255-7120
Practice Address - Fax:704-519-2840
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-12
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program