Provider Demographics
NPI:1205913274
Name:BOSCHEE, TROY A (DC, CCSP)
Entity type:Individual
Prefix:DR
First Name:TROY
Middle Name:A
Last Name:BOSCHEE
Suffix:
Gender:M
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8351 CARRIAGE HILL ALCOVE
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-2340
Mailing Address - Country:US
Mailing Address - Phone:952-445-3608
Mailing Address - Fax:952-888-7563
Practice Address - Street 1:10700 NORMANDALE BLVD
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55437-2700
Practice Address - Country:US
Practice Address - Phone:952-888-5805
Practice Address - Fax:952-888-7563
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3458111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN266219100Medicaid
MN350001702Medicare ID - Type UnspecifiedCHIROPRACTOR
MN266219100Medicaid