Provider Demographics
NPI:1528031283
Name:TROTTER, ROY L (DC)
Entity Type:Individual
Prefix:MR
First Name:ROY
Middle Name:L
Last Name:TROTTER
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 1:610 EAST BLVD
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-2902
Mailing Address - Country:US
Mailing Address - Phone:605-342-3908
Mailing Address - Fax:605-342-0250
Practice Address - Street 1:610 EAST BLVD
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-2902
Practice Address - Country:US
Practice Address - Phone:605-342-3908
Practice Address - Fax:605-342-0250
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD957111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor