Provider Demographics
NPI:1013186493
Name:TRINITY CHIROPRACTIC WELLNESS, PLLC
Entity Type:Organization
Organization Name:TRINITY CHIROPRACTIC WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:COLE
Authorized Official - Last Name:BRADBURN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-261-0202
Mailing Address - Street 1:4025 VILLAGE PARK DR
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-7044
Mailing Address - Country:US
Mailing Address - Phone:919-261-0202
Mailing Address - Fax:
Practice Address - Street 1:4025 VILLAGE PARK DR
Practice Address - Street 2:
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-7044
Practice Address - Country:US
Practice Address - Phone:919-261-0202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3801111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty