Provider Demographics
NPI:1063530962
Name:TROUTMAN, CHRISTIAN SEAN (DC)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:SEAN
Last Name:TROUTMAN
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 1:320 MAIN ST NORTH
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37030
Mailing Address - Country:US
Mailing Address - Phone:615-735-8448
Mailing Address - Fax:615-735-8446
Practice Address - Street 1:320 MAIN ST NORTH
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:TN
Practice Address - Zip Code:37030
Practice Address - Country:US
Practice Address - Phone:615-735-8448
Practice Address - Fax:615-735-8446
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000001997111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4105395OtherBCBS OF TN
U91667Medicare UPIN
3973530Medicare ID - Type Unspecified