Provider Demographics
NPI:1215343462
Name:TROMBLEY, HALEY
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:TROMBLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 SW SAINT LUCIE WEST BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-2134
Mailing Address - Country:US
Mailing Address - Phone:772-785-8500
Mailing Address - Fax:772-785-8511
Practice Address - Street 1:1430 SW SAINT LUCIE WEST BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-2134
Practice Address - Country:US
Practice Address - Phone:772-785-8500
Practice Address - Fax:772-785-8511
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11252111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor