Provider Demographics
NPI:1962258160
Name:KLINEBRIEL, TREVOR
Entity type:Individual
Prefix:
First Name:TREVOR
Middle Name:
Last Name:KLINEBRIEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1244 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-2304
Mailing Address - Country:US
Mailing Address - Phone:740-583-4206
Mailing Address - Fax:
Practice Address - Street 1:1690 CHARTWELL DR APT 202
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-7889
Practice Address - Country:US
Practice Address - Phone:740-583-4206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide