Individual
MRS. CLAUDE RUSSELL TROTTER III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
674 W WARRIOR TRL, GRAND PRAIRIE, TX 75052-6099
(214) 924-8164
Mailing address
PO BOX 543491, GRAND PRAIRIE, TX 75054-3491
(214) 924-8164
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
02/05/2009
Last updated
02/05/2009
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