Provider Demographics
NPI:1144694126
Name:TG CHIROPRACTIC
Entity type:Organization
Organization Name:TG CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:GUS
Authorized Official - Last Name:GARABEDIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:559-855-8445
Mailing Address - Street 1:612 FALLBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-7035
Mailing Address - Country:US
Mailing Address - Phone:559-855-8445
Mailing Address - Fax:559-855-8440
Practice Address - Street 1:29369 AUBERRY RD
Practice Address - Street 2:101
Practice Address - City:PRATHER
Practice Address - State:CA
Practice Address - Zip Code:93651-9784
Practice Address - Country:US
Practice Address - Phone:559-855-8445
Practice Address - Fax:559-855-8440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 32796111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty