Provider Demographics
NPI:1336195270
Name:SCHEUERMANN, TROY GRANT (DC)
Entity Type:Individual
Prefix:
First Name:TROY
Middle Name:GRANT
Last Name:SCHEUERMANN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:MR
Other - First Name:TROY
Other - Middle Name:GRANT
Other - Last Name:SCHEUERMANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:103 SOUTH 2ND ST
Mailing Address - Street 2:PO BOX 606
Mailing Address - City:FARMINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52626
Mailing Address - Country:US
Mailing Address - Phone:319-878-1234
Mailing Address - Fax:309-878-5678
Practice Address - Street 1:103 SOUTH 2ND ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:IA
Practice Address - Zip Code:52626
Practice Address - Country:US
Practice Address - Phone:319-878-1234
Practice Address - Fax:319-878-5678
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA06069111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
37109OtherBCBS
IA0455568Medicaid
37109OtherBCBS
IA0455568Medicaid