Provider Demographics
NPI:1154668242
Name:TRAHAN, GAGE ALLEN (ATC)
Entity Type:Individual
Prefix:MR
First Name:GAGE
Middle Name:ALLEN
Last Name:TRAHAN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 HEMBLING DR
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-5648
Mailing Address - Country:US
Mailing Address - Phone:318-730-1434
Mailing Address - Fax:
Practice Address - Street 1:116 HEMBLING DR
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-5648
Practice Address - Country:US
Practice Address - Phone:318-730-1434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator