Provider Demographics
NPI:1023460599
Name:TRIUNE CHIROPRACTIC LLC
Entity type:Organization
Organization Name:TRIUNE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-528-0315
Mailing Address - Street 1:57 ROBINSON ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35146-4028
Mailing Address - Country:US
Mailing Address - Phone:909-528-0315
Mailing Address - Fax:
Practice Address - Street 1:57 ROBINSON ST
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:AL
Practice Address - Zip Code:35146-4028
Practice Address - Country:US
Practice Address - Phone:909-528-0315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-08
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty