Provider Demographics
NPI:1417244872
Name:PAYTON, TRINITY TREVILLE (ELDER)
Entity Type:Individual
Prefix:MR
First Name:TRINITY
Middle Name:TREVILLE
Last Name:PAYTON
Suffix:
Gender:M
Credentials:ELDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 E CENTENNIAL PKWY
Mailing Address - Street 2:2-108
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-8114
Mailing Address - Country:US
Mailing Address - Phone:702-370-4974
Mailing Address - Fax:
Practice Address - Street 1:2929 E CENTENNIAL PKWY
Practice Address - Street 2:2-108
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-8114
Practice Address - Country:US
Practice Address - Phone:702-370-4974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner