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General NPI Number Information
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NPI Number | 1750563136
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Entity Type | Organization
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Legal Business Name | TRINITY CHIROPRACTIC INCORPORATED
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Dates
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Enumeration Date | 11/28/2007
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 1702 MAPLE ST
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City | WINNFIELD
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State | LA
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Zip | 71483-3064
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Country | US
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Telephone | 318-628-2719
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Fax | 318-628-6040
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Provider Business Mailing Address
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Address Line | 1702 MAPLE ST
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City | WINNFIELD
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State | LA
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Zip | 71483-3064
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Country | US
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Telephone | 318-628-2719
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Fax | 318-628-6040
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Authorized Official
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Title or Position | OWNER
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Name | JON E ZEAGLER
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Credential |
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Telephone | 318-352-0099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 508
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License Number State | LA
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