MEDICARE: TRINITY REHAB & WELLNESS

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	4859	TX
2	111N00000X	Chiropractor	7243	TX

General Provider Information

NPI Number	:	1265620686
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRINITY REHAB & WELLNESS

Provider Business Mailing Address
First Line	:	4033 SUMMERHILL DR
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30506-7117
Country	:	US
Telephone Number	:	770-503-9290
Fax Number	:	770-503-9405

Provider Business Practice Location Address
First Line	:	4222 TRINITY MILLS RD
Second Line	:	SUITE 114
City	:	DALLAS
State	:	TX
Zip	:	75287-7603
Country	:	US
Telephone Number	:	972-248-3101
Fax Number	:	972-248-3615

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MORGAN MULLICAN
Credential	:	D.C.
Telephone Number	:	770-503-9290

Provider Enumeration Date	:	10/10/2007
Last Update Date	:	11/20/2008

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Directions to “TRINITY REHAB & WELLNESS ” Practice Location

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