Provider Demographics
NPI:1164043642
Name:TRINITY INTEGRATED HEALTH AND WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:TRINITY INTEGRATED HEALTH AND WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:ZEAGLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:318-352-0099
Mailing Address - Street 1:366 SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-5053
Mailing Address - Country:US
Mailing Address - Phone:318-352-0099
Mailing Address - Fax:318-352-1032
Practice Address - Street 1:366 SOUTH DR
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-5053
Practice Address - Country:US
Practice Address - Phone:318-352-0099
Practice Address - Fax:318-352-1032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-06
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty