Provider Demographics
NPI:1447580832
Name:TRINITY CHIROPRACTIC
Entity type:Organization
Organization Name:TRINITY CHIROPRACTIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:HUGH
Authorized Official - Last Name:ZYLSTRA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-473-7777
Mailing Address - Street 1:7517 CUSTER RD W
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-8138
Mailing Address - Country:US
Mailing Address - Phone:253-473-7777
Mailing Address - Fax:253-473-2484
Practice Address - Street 1:7517 CUSTER RD W
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-8138
Practice Address - Country:US
Practice Address - Phone:253-473-7777
Practice Address - Fax:253-473-2484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-06
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034329111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty