Provider Demographics
NPI:1932760717
Name:SCHROCK, TREVOR JORDAN (DPT)
Entity Type:Individual
Prefix:
First Name:TREVOR
Middle Name:JORDAN
Last Name:SCHROCK
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 LYNDON FARM CT STE 300
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5005
Mailing Address - Country:US
Mailing Address - Phone:502-882-9379
Mailing Address - Fax:502-805-0526
Practice Address - Street 1:1440 VETERANS PKWY STE 400
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129-8738
Practice Address - Country:US
Practice Address - Phone:812-924-5010
Practice Address - Fax:812-924-5011
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist