Provider Demographics
NPI:1811997299
Name:TRINQUE, PATRICIA ANN (MHE, PT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:TRINQUE
Suffix:
Gender:F
Credentials:MHE, PT
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:AWALT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:60 SHUFORD RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NC
Mailing Address - Zip Code:28722-7406
Mailing Address - Country:US
Mailing Address - Phone:828-894-0277
Mailing Address - Fax:828-894-0278
Practice Address - Street 1:465 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SPINDALE
Practice Address - State:NC
Practice Address - Zip Code:28160-1235
Practice Address - Country:US
Practice Address - Phone:828-287-0999
Practice Address - Fax:828-287-0880
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP19285225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5791721OtherAETNA PROVIDER NUMBER
FLY5582Medicare UPIN
FLY5582YMedicare UPIN