Provider Demographics
NPI:1033577952
Name:TRIMBLE, QUANNESHA (DC)
Entity Type:Individual
Prefix:DR
First Name:QUANNESHA
Middle Name:
Last Name:TRIMBLE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4437 DALLIS CT
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-3274
Mailing Address - Country:US
Mailing Address - Phone:662-352-9129
Mailing Address - Fax:
Practice Address - Street 1:4437 DALLIS CT
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-3274
Practice Address - Country:US
Practice Address - Phone:662-352-9129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-05
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009608111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor