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General NPI Number Information
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NPI Number | 1851053136
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Entity Type | Organization
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Legal Business Name | TRINITY CHIROPRACTIC
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Dates
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Enumeration Date | 10/13/2021
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Last Update Date | 10/13/2021
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Provider Practice Location Address
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Address Line | 1615 STATE HIGHWAY 17 STE 2
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City | YOUNG HARRIS
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State | GA
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Zip | 30582-1877
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Country | US
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Telephone | 762-349-1777
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Fax | 762-226-2616
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Provider Business Mailing Address
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Address Line | 1615 STATE HIGHWAY 17 STE 2
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City | YOUNG HARRIS
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State | GA
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Zip | 30582-1877
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Country | US
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Telephone | 762-349-1777
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Fax | 762-226-2616
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | DR. JONATHAN CARLILE
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Credential | DC
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Telephone | 706-970-8914
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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 |
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License Number State |
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