Provider Demographics
NPI:1528310489
Name:FRAHM, TRENT JOHN
Entity type:Individual
Prefix:
First Name:TRENT
Middle Name:JOHN
Last Name:FRAHM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 6TH AVE N
Mailing Address - Street 2:SUITE 370
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-4558
Mailing Address - Country:US
Mailing Address - Phone:320-257-0066
Mailing Address - Fax:320-257-0099
Practice Address - Street 1:26 6TH AVE N
Practice Address - Street 2:SUITE 370
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-4558
Practice Address - Country:US
Practice Address - Phone:320-257-0066
Practice Address - Fax:320-257-0099
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies