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General NPI Number Information
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NPI Number | 1376819722
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Entity Type | Organization
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Legal Business Name | TRINITY FUSION HEALTHCARE LLC
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Dates
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Enumeration Date | 03/30/2012
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Last Update Date | 03/30/2012
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Provider Practice Location Address
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Address Line | 4512 SANDY WATER LN
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City | PLANO
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State | TX
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Zip | 75024-7715
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Country | US
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Telephone | 214-235-8373
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Fax |
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Provider Business Mailing Address
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Address Line | 9720 COIT RD SUITE 220-195
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City | PLANO
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State | TX
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Zip | 75025-5833
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Country | US
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Telephone | 214-235-8373
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUE H HEGEL
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Credential | DC
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Telephone | 214-235-8373
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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 | 9925
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License Number State | TX
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