Provider Demographics
NPI:1255680583
Name:NEW-START HEALTH CENTER LLC
Entity Type:Organization
Organization Name:NEW-START HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TRENT
Authorized Official - Middle Name:D
Authorized Official - Last Name:MOZINGO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:812-799-0668
Mailing Address - Street 1:3780 W JONATHAN MOORE PIKE
Mailing Address - Street 2:STE 160
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-9429
Mailing Address - Country:US
Mailing Address - Phone:812-799-0668
Mailing Address - Fax:812-799-0670
Practice Address - Street 1:3780 W JONATHAN MOORE PIKE
Practice Address - Street 2:STE 160
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-9429
Practice Address - Country:US
Practice Address - Phone:812-799-0668
Practice Address - Fax:812-799-0670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-31
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002618A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty