Provider Demographics
NPI:1417663311
Name:TROUTMAN, BRENTON (DC)
Entity Type:Individual
Prefix:DR
First Name:BRENTON
Middle Name:
Last Name:TROUTMAN
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 1:11001 HAUSER ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66210-3708
Mailing Address - Country:US
Mailing Address - Phone:913-322-4100
Mailing Address - Fax:
Practice Address - Street 1:11001 HAUSER ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66210-3708
Practice Address - Country:US
Practice Address - Phone:913-322-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-06241111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation