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General NPI Number Information
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NPI Number | 1144694126
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Entity Type | Organization
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Legal Business Name | TG CHIROPRACTIC
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Dates
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Enumeration Date | 11/13/2015
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Last Update Date | 11/13/2015
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Provider Practice Location Address
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Address Line | 29369 AUBERRY RD 101
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City | PRATHER
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State | CA
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Zip | 93651-9784
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Country | US
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Telephone | 559-855-8445
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Fax | 559-855-8440
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Provider Business Mailing Address
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Address Line | 612 FALLBROOK AVE
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City | CLOVIS
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State | CA
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Zip | 93611-7035
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Country | US
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Telephone | 559-855-8445
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Fax | 559-855-8440
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Authorized Official
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Title or Position | OWNER
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Name | DR. TROY GUS GARABEDIAN
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Credential | D.C.
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Telephone | 559-855-8445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC 32796
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License Number State | CA
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