MEDICARE: TRINITY CHIROPRACTIC PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH6336	FL

General Provider Information

NPI Number	:	1114143708
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRINITY CHIROPRACTIC PA

Provider Business Mailing Address
First Line	:	2515 NORTHBROOKE PLAZA DR
Second Line	:	SUITE 102
City	:	NAPLES
State	:	FL
Zip	:	34119-8088
Country	:	US
Telephone Number	:	239-597-6099
Fax Number	:	239-597-6987

Provider Business Practice Location Address
First Line	:	2515 NORTHBROOKE PLAZA DR
Second Line	:	SUITE 102
City	:	NAPLES
State	:	FL
Zip	:	34119-8088
Country	:	US
Telephone Number	:	239-597-6099
Fax Number	:	239-597-6987

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. GREG LOMAN
Credential	:	DC
Telephone Number	:	239-597-6099

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	10/30/2007

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Directions to “TRINITY CHIROPRACTIC PA ” Practice Location

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