Provider Demographics
NPI:1902887284
Name:TRUAX, DAVID E (DC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:E
Last Name:TRUAX
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20700 CHIPPENDALE AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:FARMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55024
Mailing Address - Country:US
Mailing Address - Phone:651-460-9449
Mailing Address - Fax:612-326-9581
Practice Address - Street 1:20700 CHIPPENDALE AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:FARMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55024
Practice Address - Country:US
Practice Address - Phone:651-460-6566
Practice Address - Fax:612-279-2148
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1020111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN178025500OtherMN HEALTHCARE PROGRAMS
MN56688TROtherBCBSM
MN56688TROtherBCBSM