Provider Demographics
NPI:1447783824
Name:MCCALL, TRINE SPANGGAARD (LPTA)
Entity Type:Individual
Prefix:MRS
First Name:TRINE
Middle Name:SPANGGAARD
Last Name:MCCALL
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:TRINE
Other - Middle Name:SPANGGAARD
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPTA
Mailing Address - Street 1:8254 ATLEE RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-1844
Mailing Address - Country:US
Mailing Address - Phone:804-764-7096
Mailing Address - Fax:
Practice Address - Street 1:8254 ATLEE RD
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-1844
Practice Address - Country:US
Practice Address - Phone:804-764-7096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306601318225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant