Healthcare Provider Details

I. General information

NPI: 1972590875
Provider Name (Legal Business Name): G. BRIAN TROLLOPE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12821 N CAVE CREEK RD SUITE #101
PHOENIX AZ
85022-5862
US

IV. Provider business mailing address

12821 N CAVE CREEK RD SUITE #101
PHOENIX AZ
85022-5862
US

V. Phone/Fax

Practice location:
  • Phone: 602-493-7420
  • Fax: 602-493-2246
Mailing address:
  • Phone: 602-493-7420
  • Fax: 602-493-2246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4238
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: