Provider Demographics
NPI:1457451452
Name:DOUP-TROYER, KATHLEEN JEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:JEAN
Last Name:DOUP-TROYER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 CARTER AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-1602
Mailing Address - Country:US
Mailing Address - Phone:937-593-2751
Mailing Address - Fax:937-593-4062
Practice Address - Street 1:108 CARTER AVE
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-1602
Practice Address - Country:US
Practice Address - Phone:937-593-2751
Practice Address - Fax:937-593-4062
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2627111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2647489Medicaid
OHU69938Medicare UPIN
OH0844531Medicare PIN