Provider Demographics
NPI:1194200493
Name:TRINITY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:TRINITY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ISZLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:307-267-6637
Mailing Address - Street 1:19504 N 68TH AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-5565
Mailing Address - Country:US
Mailing Address - Phone:307-267-6637
Mailing Address - Fax:
Practice Address - Street 1:18275 N 59TH AVE STE 178
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-1254
Practice Address - Country:US
Practice Address - Phone:602-603-5444
Practice Address - Fax:602-603-5445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty