Provider Demographics
NPI:1891092318
Name:TROTTIER CHIROPRACTIC
Entity Type:Organization
Organization Name:TROTTIER CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:TROTTIER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-945-1894
Mailing Address - Street 1:10105 68TH ST
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53142-8379
Mailing Address - Country:US
Mailing Address - Phone:262-945-1894
Mailing Address - Fax:
Practice Address - Street 1:3120 80TH ST
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-4946
Practice Address - Country:US
Practice Address - Phone:262-942-9955
Practice Address - Fax:262-942-9958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-18
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty