Provider Demographics
NPI:1376390856
Name:TRAIL TOWN CHIROPRACTIC PC
Entity type:Organization
Organization Name:TRAIL TOWN CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:FOLTZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:276-525-2380
Mailing Address - Street 1:560 BOWLIN ST
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:VA
Mailing Address - Zip Code:24236-2317
Mailing Address - Country:US
Mailing Address - Phone:276-525-2380
Mailing Address - Fax:
Practice Address - Street 1:101 S SHADY AVE
Practice Address - Street 2:
Practice Address - City:DAMASCUS
Practice Address - State:VA
Practice Address - Zip Code:24236-3128
Practice Address - Country:US
Practice Address - Phone:276-525-2380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-02
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty