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General NPI Number Information
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NPI Number | 1518949841
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Entity Type | Organization
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Legal Business Name | TROUT CHIROPRACTIC CENTER PC
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Dates
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Enumeration Date | 11/14/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 22 N MAIN ST
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City | MIFFLINTOWN
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State | PA
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Zip | 17059-1003
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Country | US
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Telephone | 717-436-8281
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Fax | 717-436-5025
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Provider Business Mailing Address
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Address Line | 22 N MAIN ST
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City | MIFFLINTOWN
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State | PA
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Zip | 17059-1003
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Country | US
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Telephone | 717-436-9885
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Fax | 717-436-5025
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GARY W TROUT
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Credential | DC
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Telephone | 717-436-9885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 795
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2301004216
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC001304L
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License Number State | PA
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