Provider Demographics
NPI:1598038481
Name:TRAENT LLC
Entity type:Organization
Organization Name:TRAENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:662-349-0707
Mailing Address - Street 1:60 PHYSICIANS LN
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-6122
Mailing Address - Country:US
Mailing Address - Phone:662-349-0707
Mailing Address - Fax:
Practice Address - Street 1:60 PHYSICIANS LN
Practice Address - Street 2:SUITE 1
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-6122
Practice Address - Country:US
Practice Address - Phone:662-349-0707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY EAR NOSE AND THROAT CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center