Healthcare Provider Details

I. General information

NPI: 1316914658
Provider Name (Legal Business Name): IAN THOMAS FROHN D.C., ATC/L
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 E MAIN ST SUITE 202
MILFORD MA
01757-2807
US

IV. Provider business mailing address

16 PROSPECT ST
HOPEDALE MA
01747-1227
US

V. Phone/Fax

Practice location:
  • Phone: 508-473-2501
  • Fax: 508-473-2550
Mailing address:
  • Phone: 508-259-0885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number2647
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: