Provider Demographics
NPI:1356443717
Name:TROST, BRANDON GALE (DC)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:GALE
Last Name:TROST
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MCPHERSON
Mailing Address - State:KS
Mailing Address - Zip Code:67460-3601
Mailing Address - Country:US
Mailing Address - Phone:620-504-6344
Mailing Address - Fax:866-544-7606
Practice Address - Street 1:1319 E 1ST ST
Practice Address - Street 2:
Practice Address - City:MCPHERSON
Practice Address - State:KS
Practice Address - Zip Code:67460-3601
Practice Address - Country:US
Practice Address - Phone:620-504-6344
Practice Address - Fax:866-544-7606
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-4626111N00000X
KS176574225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS060359Medicare PIN
KS176574Medicare Oscar/Certification
KSU76614Medicare UPIN