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General NPI Number Information
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NPI Number | 1730365651
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Entity Type | Organization
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Legal Business Name | TRANQUILITY HEALTH CENTERS, PC
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 1121 BRIARCREST DR SUITE #100
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City | BRYAN
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State | TX
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Zip | 77802-2505
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Country | US
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Telephone | 979-268-0786
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Fax | 979-846-2136
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Provider Business Mailing Address
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Address Line | PO BOX 12410
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City | COLLEGE STATION
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State | TX
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Zip | 77842-2410
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Country | US
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Telephone | 979-774-5300
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Fax | 979-776-5173
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | JERRY LLOYD
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Credential | DC
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Telephone | 979-774-5300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 8580
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License Number State | TX
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