Provider Demographics
NPI:1417985607
Name:TRINKAUS, MARVIN II (ATC)
Entity Type:Individual
Prefix:
First Name:MARVIN
Middle Name:
Last Name:TRINKAUS
Suffix:II
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 1:895 SINGING HILLS DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-1700
Mailing Address - Country:US
Mailing Address - Phone:678-461-6192
Mailing Address - Fax:404-463-9659
Practice Address - Street 1:125 DECATUR ST, SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3201
Practice Address - Country:US
Practice Address - Phone:404-651-3172
Practice Address - Fax:404-463-9659
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0006462255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer