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General NPI Number Information
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NPI Number | 1508138041
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Entity Type | Individual
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Provider Name | TRENT D MOZINGO D.C.
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Gender | Male
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Dates
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Enumeration Date | 01/30/2012
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Last Update Date | 01/30/2012
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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 | 47201-9430
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Country | US
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Telephone | 812-569-5685
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Fax |
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Provider Business Mailing Address
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Address Line | 1899 N COUNTY ROAD 950 W
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City | HOLTON
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State | IN
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Zip | 47023-8483
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Country | US
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Telephone | 812-569-5685
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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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