Trevisan, David

Trevisan, David is an individual health care provider with primary practice located at 1407 E Michigan Ave , Jackson MI 49202-3517. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist, which is considered as his primary health care specialty. Trevisan, David can be contacted via phone (517) 784-1142.

Contact Information

Primary practice address
1407 E Michigan Ave Jackson MI 49202-3517
Phone: (517) 784-1142
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist 222Z00000X

Profile Details

NPI number 1184149551
LBN Legal business name Trevisan, David
Credentials MSOP, CO
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 7th, 2017
Last updated Jul 21st, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184149551 NPPES
Michigan MEDICAID 222Z00000X

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