=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831693340
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TRUFIT CHIROPRACTIC PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/20/2018
-----------------------------------------------------
Last Update Date | 03/20/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 125 E OTTERMAN ST STE 1
-----------------------------------------------------
City | GREENSBURG
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15601-2509
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-858-4060
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 201 BLACKWOOD DR
-----------------------------------------------------
City | GREENSBURG
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15601-5919
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-689-9307
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. JASON SWEENEY
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 724-689-9307
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC011342
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------