Healthcare Provider Details

I. General information

NPI: 1003845397
Provider Name (Legal Business Name): TODD T FRISCH D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 02/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 BAXTER RD SUITE 8
CHESTERFIELD MO
63017-7032
US

IV. Provider business mailing address

510 BAXTER RD SUITE 8
CHESTERFIELD MO
63017-7032
US

V. Phone/Fax

Practice location:
  • Phone: 636-207-6600
  • Fax: 636-207-6631
Mailing address:
  • Phone: 636-207-6600
  • Fax: 636-207-6631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number004519
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: