Provider Demographics
NPI:1205002573
Name:JOHNS, TRENTON LEE (DC)
Entity type:Individual
Prefix:DR
First Name:TRENTON
Middle Name:LEE
Last Name:JOHNS
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 1:9204 TAYLORSVILLE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-1788
Mailing Address - Country:US
Mailing Address - Phone:502-267-3040
Mailing Address - Fax:502-267-0415
Practice Address - Street 1:9204 TAYLORSVILLE RD STE 110
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-1788
Practice Address - Country:US
Practice Address - Phone:502-267-3040
Practice Address - Fax:502-267-0415
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5120111N00000X
KY249500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor