Provider Demographics
NPI:1417550096
Name:AUKERMAN, TREVOR DANIEL
Entity Type:Individual
Prefix:
First Name:TREVOR
Middle Name:DANIEL
Last Name:AUKERMAN
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 1:12825 S PARKER RD
Mailing Address - Street 2:
Mailing Address - City:DELTON
Mailing Address - State:MI
Mailing Address - Zip Code:49046-9436
Mailing Address - Country:US
Mailing Address - Phone:269-953-6549
Mailing Address - Fax:
Practice Address - Street 1:12825 S PARKER RD
Practice Address - Street 2:
Practice Address - City:DELTON
Practice Address - State:MI
Practice Address - Zip Code:49046-9436
Practice Address - Country:US
Practice Address - Phone:269-953-6549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer