Provider Demographics
NPI:1851403802
Name:STORLIE, TROY E (DC)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:E
Last Name:STORLIE
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 1:40 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-1955
Mailing Address - Country:US
Mailing Address - Phone:218-477-1120
Mailing Address - Fax:218-477-1121
Practice Address - Street 1:40 4TH ST N
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-1955
Practice Address - Country:US
Practice Address - Phone:218-477-1120
Practice Address - Fax:218-477-1121
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3182111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN932217500Medicaid
MN350002917Medicare PIN
MN932217500Medicaid