Provider Demographics
NPI:1346412160
Name:DECKER, TROY C (BOCP, CFO)
Entity Type:Individual
Prefix:MR
First Name:TROY
Middle Name:C
Last Name:DECKER
Suffix:
Gender:M
Credentials:BOCP, CFO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4754
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-4754
Mailing Address - Country:US
Mailing Address - Phone:910-295-2828
Mailing Address - Fax:910-295-2996
Practice Address - Street 1:325 PAGE RD
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8751
Practice Address - Country:US
Practice Address - Phone:910-295-2828
Practice Address - Fax:910-295-2996
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-01
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier