Provider Demographics
NPI:1851053136
Name:TRINITY CHIROPRACTIC
Entity type:Organization
Organization Name:TRINITY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLILE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:706-970-8914
Mailing Address - Street 1:1615 STATE HIGHWAY 17 STE 2
Mailing Address - Street 2:
Mailing Address - City:YOUNG HARRIS
Mailing Address - State:GA
Mailing Address - Zip Code:30582-1877
Mailing Address - Country:US
Mailing Address - Phone:762-349-1777
Mailing Address - Fax:762-226-2616
Practice Address - Street 1:1615 STATE HIGHWAY 17 STE 2
Practice Address - Street 2:
Practice Address - City:YOUNG HARRIS
Practice Address - State:GA
Practice Address - Zip Code:30582-1877
Practice Address - Country:US
Practice Address - Phone:762-349-1777
Practice Address - Fax:762-226-2616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty