Provider Demographics
NPI:1578716544
Name:TREGLE CHIROPRACTIC CLINIC, LLC
Entity Type:Organization
Organization Name:TREGLE CHIROPRACTIC CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:J
Authorized Official - Last Name:TREGLE
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:985-312-2031
Mailing Address - Street 1:1101A 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MORGAN CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70380-1915
Mailing Address - Country:US
Mailing Address - Phone:985-312-2031
Mailing Address - Fax:
Practice Address - Street 1:1101A 8TH ST
Practice Address - Street 2:
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-1915
Practice Address - Country:US
Practice Address - Phone:985-312-2031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0529261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center