Provider Demographics
NPI:1326266453
Name:SALTER, TRINITY PURVIS (PT)
Entity Type:Individual
Prefix:
First Name:TRINITY
Middle Name:PURVIS
Last Name:SALTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12630 LAKELAND DR
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:LA
Mailing Address - Zip Code:70785-8208
Mailing Address - Country:US
Mailing Address - Phone:225-772-1599
Mailing Address - Fax:
Practice Address - Street 1:14608 S HARRELLS FERRY RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-2926
Practice Address - Country:US
Practice Address - Phone:225-388-5534
Practice Address - Fax:225-388-5537
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA06937225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist