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General NPI Number Information
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NPI Number | 1255680583
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Entity Type | Organization
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Legal Business Name | NEW-START HEALTH CENTER LLC
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Dates
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Enumeration Date | 08/31/2012
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Last Update Date | 08/31/2012
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Provider Practice Location Address
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Address Line | 3780 W JONATHAN MOORE PIKE STE 160
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City | COLUMBUS
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State | IN
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Zip | 47201-9429
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Country | US
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Telephone | 812-799-0668
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Fax | 812-799-0670
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Provider Business Mailing Address
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Address Line | 3780 W JONATHAN MOORE PIKE STE 160
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City | COLUMBUS
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State | IN
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Zip | 47201-9429
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Country | US
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Telephone | 812-799-0668
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Fax | 812-799-0670
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. TRENT D MOZINGO
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Credential | DC
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Telephone | 812-799-0668
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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 | 08002618A
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License Number State | IN
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