Provider Demographics
NPI:1619973385
Name:TROUMBLY, SHALYMAR C (DC)
Entity Type:Individual
Prefix:DR
First Name:SHALYMAR
Middle Name:C
Last Name:TROUMBLY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SHALYMAR
Other - Middle Name:C
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2711 COMMERCE DR NW STE 300
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-3240
Mailing Address - Country:US
Mailing Address - Phone:507-206-4660
Mailing Address - Fax:507-206-4783
Practice Address - Street 1:2711 COMMERCE DR NW STE 300
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-3240
Practice Address - Country:US
Practice Address - Phone:507-206-4660
Practice Address - Fax:507-206-4783
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2015-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3659111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN281M0LIOtherBCBS CONTRACTING PROVIDER
MN456719600OtherMN CARE
MN291M7NEOtherBCBS INDIVIDUAL PROVIDER
MN291M7NEOtherBCBS INDIVIDUAL PROVIDER
MN456719600OtherMN CARE