Provider Demographics
NPI:1053671487
Name:STYAN, TREVOR J
Entity Type:Individual
Prefix:
First Name:TREVOR
Middle Name:J
Last Name:STYAN
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:BOX 1731
Mailing Address - Street 2:510 CARIBOU CR
Mailing Address - City:TISDALE
Mailing Address - State:SASKATCHEWAN
Mailing Address - Zip Code:S0E1T0
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BOX 1731
Practice Address - Street 2:510 CARIBOU CR
Practice Address - City:TISDALE
Practice Address - State:SASKATCHEWAN
Practice Address - Zip Code:S0E1T0
Practice Address - Country:CA
Practice Address - Phone:306-873-4168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program