Provider Demographics
NPI:1942750955
Name:TERRI TRUESDALE DC LLC
Entity Type:Organization
Organization Name:TERRI TRUESDALE DC LLC
Other - Org Name:FIT BEING CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TRUESDALE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-703-4504
Mailing Address - Street 1:700 FRONT ST S
Mailing Address - Street 2:B203
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-4251
Mailing Address - Country:US
Mailing Address - Phone:360-703-4504
Mailing Address - Fax:
Practice Address - Street 1:700 FRONT ST S
Practice Address - Street 2:B203
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-4251
Practice Address - Country:US
Practice Address - Phone:360-703-4504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-13
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty