| Trinity Wellness Center, Llc. | |
|
9434 S Main St Ste 1100 Jonesboro GA 30236-6092 | |
| (770) 478-1300 | |
| (770) 478-9385 |
| Full Name | Trinity Wellness Center, Llc. |
|---|---|
| Speciality | Chiropractor |
| Location | 9434 S Main St Ste 1100, Jonesboro, Georgia |
| Authorized Official Name and Position | Genia Sword (OWNER) |
| Authorized Official Contact | 7704781300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trinity Wellness Center, Llc. 9434 S Main St Ste 1100 Jonesboro GA 30236-6092 Ph: (770) 478-1300 | Trinity Wellness Center, Llc. 9434 S Main St Ste 1100 Jonesboro GA 30236-6092 Ph: (770) 478-1300 |
| NPI Number | 1518466739 |
|---|---|
| Provider Enumeration Date | 02/02/2018 |
| Last Update Date | 02/02/2018 |
| Medicare PECOS PAC ID | 8527314780 |
|---|---|
| Medicare Enrollment ID | O20180702002318 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518466739 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 19354 (Georgia) | Secondary |
| 111N00000X | Chiropractor | CHIR006745 (Georgia) | Primary |
| Provider Name | Genia C Sword Fraser |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1891868949 PECOS PAC ID: 3870509409 Enrollment ID: I20060307000493 |
| Provider Name | Luther Vance |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205001542 PECOS PAC ID: 8325109366 Enrollment ID: I20160809002443 |
| Provider Name | Christina Tyree Gary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750951349 PECOS PAC ID: 3375915606 Enrollment ID: I20230214001194 |
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