Healthcare Provider Details

I. General information

NPI: 1124044094
Provider Name (Legal Business Name): FRAZETTA CHIROPRACTIC HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

846 PITTSBURGH ST
SPRINGDALE PA
15144
US

IV. Provider business mailing address

846 PITTSBURGH ST
SPRINGDALE PA
15144
US

V. Phone/Fax

Practice location:
  • Phone: 724-274-9440
  • Fax: 724-274-0858
Mailing address:
  • Phone: 724-274-9440
  • Fax: 724-274-0858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC005110L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC005111L
License Number StatePA

VIII. Authorized Official

Name: MR. SEBASTIAN JOHN FRAZETTA
Title or Position: OWNER CHIROPRACTOR
Credential: DC
Phone: 724-274-9440