Provider Demographics
NPI:1801661947
Name:TURK, TREVOR (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:
Last Name:TURK
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7677 SOUTHLAND RD
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95336-8493
Mailing Address - Country:US
Mailing Address - Phone:530-701-2612
Mailing Address - Fax:
Practice Address - Street 1:1222 W COLONY RD STE 130
Practice Address - Street 2:
Practice Address - City:RIPON
Practice Address - State:CA
Practice Address - Zip Code:95366-9482
Practice Address - Country:US
Practice Address - Phone:209-624-1288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA305221225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist