MEDICARE: SCOTT LEWIS FRIZZELL D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	9265	TX

General Provider Information

NPI Number	:	1497926182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT LEWIS FRIZZELL D.C.

Provider Business Mailing Address
First Line	:	408 S MAIN ST STE B
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-3183
Country	:	US
Telephone Number	:	817-453-9797
Fax Number	:	817-453-9780

Provider Business Practice Location Address
First Line	:	1804 OWEN CT SUITE 102
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063
Country	:	US
Telephone Number	:	817-453-9797
Fax Number	:	817-453-9780

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2008
Last Update Date	:	04/20/2017

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