Provider Demographics
NPI:1760215255
Name:TRENT, BRANDON ALAN (PT, DPT)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:ALAN
Last Name:TRENT
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2259 SANDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-2593
Mailing Address - Country:US
Mailing Address - Phone:423-317-9699
Mailing Address - Fax:423-317-9225
Practice Address - Street 1:1047 HIGHWAY 92 S
Practice Address - Street 2:
Practice Address - City:DANDRIDGE
Practice Address - State:TN
Practice Address - Zip Code:37725-4740
Practice Address - Country:US
Practice Address - Phone:865-397-5073
Practice Address - Fax:865-397-7846
Is Sole Proprietor?:No
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15848225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist