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General NPI Number Information
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NPI Number | 1124084074
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Entity Type | Individual
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Provider Name | COLIN W FROGLEY DC
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Gender | Male
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Dates
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Enumeration Date | 04/20/2006
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Last Update Date | 10/11/2011
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Provider Practice Location Address
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Address Line | 4769 SOQUEL DR
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City | SOQUEL
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State | CA
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Zip | 95073-2457
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Country | US
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Telephone | 831-462-3350
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Fax | 831-462-6258
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Provider Business Mailing Address
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Address Line | 4769 SOQUEL DR
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City | SOQUEL
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State | CA
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Zip | 95073-2457
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Country | US
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Telephone | 831-462-3350
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Fax | 831-462-6258
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 17438
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License Number State | CA
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