Healthcare Provider Details

I. General information

NPI: 1437283926
Provider Name (Legal Business Name): TRINITY HEALTH CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MERCADO ST SUITE 150
DURANGO CO
81301-7300
US

IV. Provider business mailing address

3438 COUNTY ROAD 122
HESPERUS CO
81326-8500
US

V. Phone/Fax

Practice location:
  • Phone: 970-375-2273
  • Fax: 970-375-2207
Mailing address:
  • Phone: 970-375-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number928
License Number StateCO

VIII. Authorized Official

Name: MR. TIMOTHY PARKER HAWBAKER
Title or Position: PARTNER
Credential: L.AC.
Phone: 970-375-2273