Provider Demographics
NPI:1528480977
Name:TRENT, EMILY C (PT, DPT, MS)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:C
Last Name:TRENT
Suffix:
Gender:F
Credentials:PT, DPT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1456 MCLENDON DR STE B
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-1848
Mailing Address - Country:US
Mailing Address - Phone:404-468-4132
Mailing Address - Fax:
Practice Address - Street 1:1456 MCLENDON DR STE B
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-1848
Practice Address - Country:US
Practice Address - Phone:404-728-9766
Practice Address - Fax:404-728-9166
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-19
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT011361225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist